Jasper Podiatry Center, P.C.

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

157 Issued in AL

Legal business name

JASPER PODIATRY CENTER, P.C.

Practice address

1800 Birmingham Ave
Jasper, AL 35501-5461

Phone

(205) 384-4474

Fax

(205) 384-4428

NPI assigned

Sep 6, 2007

Last updated

Oct 6, 2023By 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. John S Odle, DPMNPI 1902984834

Title

Chairman

Phone

(205) 924-4474

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AL2 enrollments

Enrollment records 2

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.

• John Scot Odle, D.P.M.

  • Podiatrist
  • Jasper, AL
  • NPI 1902984834
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1558556225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 20TH AVE E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355014024",
            "telephone_number": "120-538-4447",
            "fax_number": "205-384-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BIRMINGHAM AVE",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355015461",
            "telephone_number": "205-384-4474",
            "fax_number": "205-384-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASPER PODIATRY CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "ODLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "205-924-4474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "AL",
            "license": "157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480034067",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U58040",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF ALABAMA",
            "identifier": "051176296",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "157",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasper Gastroenterology Inc.
• Jasper General Surgery
• Jasper Hearing Center, LLC
• Jasper Medical Supply, Inc.
• Jasper Pediatric Dentistry, LLC
• Jasper Senior Living LLC (The Terrace Senior Living Community)
• Jasper Urgent Care
• Miali Praytor Jennings, CRNP
• Jernigan Healthcare, Inc.
• Jerry L. Boshell, D.M.D., P.C.

• Podiatric Clinic/Center in Jasper, AL
• Providers in Jasper, AL by specialty
• Podiatric Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.