Individual provider Active NPI

Ronald Hunter Odom Jr.

  • Certified Registered Nurse Anesthetist
  • Albany, GA
National Provider Identifier
1568754646
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN188403 Issued in GA
Practice address
417 W 3Rd Ave
Albany, GA 31701-1943
Phone
(229) 312-1000
NPI assigned
May 9, 2011
Last updated
Jun 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN188403 GA Primary

Addresses

Primary practice location

417 W 3Rd Ave
Albany, GA 31701-1943

Mailing address

500 W 3Rd Ave
Ste 101
Albany, GA 31701-1985
Phone (229) 312-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110623000105 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153509013 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valdosta Anesthesia Associates, P.C.Group PAC ID 0941296636, 42 clinicians

Practice addresses (Care Compare)

2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 244-6852

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN188403GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Valdosta Anesthesia Associates, P.C. CurrentSince Dec 1, 2023 Accepting new patients
RG Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Oct 1, 2011 Accepting new patients
JC Anesthesia LLC CurrentSince Oct 1, 2023 Accepting new patients
Au Anesthesiology LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 7, 2021 Accepting new patients
Phoebe Putney Memorial Hospital Inc Current Accepting new patients
Phoebe Putney Memorial Hospital, Inc. Past Accepting new patients
Phoebe Putney Memorial Hospital, Inc. Past Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

3303 Glynn Ave
Brunswick, GA 31520
Phone (912) 354-4800

710 N Irwin Ave
Ocilla, GA 31774
Phone (229) 468-3800

11 John Maddox Dr NW
Rome, GA 30165
Phone (406) 295-3992

5669 Ptree Dunwoody Rd NE
Ste 210
Sandy Springs, GA 30342
Phone (404) 255-4333

728 E 67th St
Savannah, GA 31405
Phone (912) 352-3120

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

4120 N Valdosta Rd
Ste B
Valdosta, GA 31602
Phone (229) 244-2068

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

1090 Experiment Station Rd
Unit 529
Watkinsville, GA 30677
Phone (706) 621-4108

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1568754646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W 3RD AVE",
            "address_2": "STE 101",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011985",
            "telephone_number": "229-312-5800",
            "fax_number": "229-889-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011943",
            "telephone_number": "229-312-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "RONALD",
        "middle_name": "HUNTER",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-09",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN188403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.