Active NPI
Justin Wallace Odgers, PA-C
- Physician Assistant
- Norfolk, VA
National Provider Identifier
1487305215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 6379 Center Dr
Norfolk, VA 23502-4102 - Phone
- (757) 467-4200
- NPI assigned
- Jan 13, 2022
- Last updated
- Feb 28, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
6379 Center Dr
Norfolk, VA 23502-4102
Mailing address
403 24TH St Apt 11
Virginia Beach, VA 23451-3262
Phone (413) 588-7344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2800 Godwin Blvd
Suffolk, VA 23434-8038
Phone (757) 686-3508
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.87 of 100
- Quality
- 95.04
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Norfolk, VA
- NPI 1033136841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646006400000",
"number": "1487305215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 24TH ST APT 11",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234513262",
"telephone_number": "413-588-7344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6379 CENTER DR",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235024102",
"telephone_number": "757-467-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODGERS",
"first_name": "JUSTIN",
"middle_name": "WALLACE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-13",
"last_updated": "2022-02-28",
"certification_date": "2022-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.