Individual provider Active NPI

Hope Elizabeth Odom

  • Primary Care Nurse Practitioner
  • College Station, TX
National Provider Identifier
1609411263
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP143434 Issued in TX
Practice address
2911 Texas Ave S Ste 202
College Station, TX 77845-5388
Phone
(979) 695-3570
NPI assigned
Nov 7, 2019
Last updated
Nov 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP143434 TX Primary

Addresses

Primary practice location

2911 Texas Ave S Ste 202
College Station, TX 77845-5388

Mailing address

1550 Crescent Pointe Pkwy Apt 4108
College Station, TX 77845-7396
Phone (979) 204-3987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191204001662 TX Practitioner - Nurse Practitioner 8426481573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BCS Abundant Life Family PracticeGroup PAC ID 8123006772, 3 clinicians

Practice addresses (Care Compare)

2911 Texas Ave S
Suite 202
College Station, TX 77845-5388
Phone (979) 695-3570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BCS Abundant Life Family Practice CurrentSince Dec 1, 2019 Accepting new patients

Locations

2911 Texas Ave S
Ste 202
College Station, TX 77845
Phone (979) 204-3987

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.

Hospital & facility affiliations 2

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": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1609411263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 CRESCENT POINTE PKWY APT 4108",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778457396",
            "telephone_number": "979-204-3987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 TEXAS AVE S STE 202",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455388",
            "telephone_number": "979-695-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "HOPE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP143434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.