Kreslyn B Odum & Associates, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2242 Issued in GA

Legal business name

KRESLYN B ODUM & ASSOCIATES, PC

Doing business as

Family Eye Care

Practice address

420 W Cherry St
Jesup, GA 31545-1435

Phone

(478) 553-0007

Fax

(478) 552-6619

NPI assigned

May 8, 2007

Last updated

Jan 15, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kreslyn B Odum, ODNPI 1093778656

Title

Physician

Phone

(478) 553-0007

Specialties & licenses 1

Addresses

Other names 1

• Family Eye Care Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kreslyn Barron Odum, OD

  • Optometrist
  • Jesup, GA
  • NPI 1093778656
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1508079179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W CHERRY ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451435",
            "telephone_number": "478-553-0007",
            "fax_number": "478-552-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W CHERRY ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451435",
            "telephone_number": "478-553-0007",
            "fax_number": "478-552-6619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Sandersville",
            "state": "GA",
            "postal_code": "310821971",
            "country_code": "US",
            "telephone_number": "478-553-0007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KRESLYN B ODUM & ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "ODUM",
        "authorized_official_first_name": "KRESLYN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "478-553-0007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "2242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• J Lex Kenerly III, MD
• Shae Kennedy
• Jonathan Paul Kiff, PA-C
• Halei Alise Kirkland, FNP-BC
• Heather A Klein
• Kim Kathleen Kuebler, NP
• Hannah Elaine Kurrasch, RBT
• Marissa Lairsey
• Lawson Physical Therapy (Advantage Physical Therapy)
• William Reid Lawson, PT,DPT

• Optometrist in Jesup, GA
• Providers in Jesup, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.