Odyssey House Inc Louisiana

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ODYSSEY HOUSE INC LOUISIANA

Practice address

1125 N Tonti St
Medical Clinic
New Orleans, LA 70119-3549

Phone

(504) 378-7816

NPI assigned

Feb 18, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Leigh Ann De Monredon, C-ANP

Title

Clinic Director

Phone

(504) 378-7816

Specialties & licenses 1

Addresses

Other names 1

• Odyssey House Community Clinic Other name

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Odyssey House Louisiana Inc

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
  • NPI 1932578408

  O20110316000647

  Same enrollment

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297987200000",
    "number": "1548567001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 N TONTI ST",
            "address_2": "MEDICAL CLINIC",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701193549",
            "telephone_number": "504-378-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 N TONTI ST",
            "address_2": "MEDICAL CLINIC",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701193549",
            "telephone_number": "504-378-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY HOUSE INC LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-18",
        "last_updated": "2011-02-18",
        "status": "A",
        "authorized_official_last_name": "DE MONREDON",
        "authorized_official_first_name": "LEIGH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "504-378-7816",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "C-ANP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Odyssey House Community Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John-Mark O Odero, MD
• Randall Odom
• La' Nyia Jameelah Odoms, MD, MSPH, M.ED
• Ulysses Odoms IV
• Odyssey House Inc Louisiana
• Odyssey House Inc. la
• Odyssey House Louisiana Inc
• Odyssey House Louisiana, Inc
• Odyssey House Louisiana, Inc (OHL Detox)
• Odyssey House Louisiana, Inc

• Clinic/Center in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; 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.