Individual provider Active NPI

Odell P. Still, DO

  • Family Medicine Physician
  • Cochran, GA
National Provider Identifier
1609868058
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37085 Issued in GA
Practice address
136 W Dykes St
Cochran, GA 31014
Phone
(478) 934-0030
Fax
(478) 783-3730
NPI assigned
Aug 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37085 GA Primary

Addresses

Primary practice location

136 W Dykes St
Cochran, GA 31014

Mailing address

PO Box 1297
Hawkinsville, GA 31036-7297
Phone (478) 783-0299

Other practice location 1

1811 Manning Dr
Vidalia, GA 30474-8921
Phone (912) 537-0614

Other practice location 2

1811 Manning Dr
Vidalia, GA 30474-8921
Phone (912) 537-0614

Other identifiers 1

IdentifierTypeStateIssuer
000539624OMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37085GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Georgia Radiology Associates, LLC CurrentSince Apr 1, 2023 Accepting new patients
Gordonia Emergency Physicians Past Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients
Memorial Health Urgentone, Inc. Family Medicine Past Accepting new patients

Locations

302 S Wayne St
Alma, GA 31510
Phone (912) 632-8961

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

391 S 1st St
Jesup, GA 31545
Phone (912) 427-8433

116 W Thigpen Ave
Lakeland, GA 31635
Phone (229) 482-8440

400 Cedar St
Metter, GA 30439
Phone (912) 685-1726

247 S Main St
Reidsville, GA 30453
Phone (478) 787-6255

117 Kite Rd
Swainsboro, GA 30401
Phone (248) 972-8725

215 Mims Rd
Sylvania, GA 30467
Phone (912) 557-1207

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1609868058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1297",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310367297",
            "telephone_number": "478-783-0299",
            "fax_number": "478-783-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 W DYKES ST",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "31014",
            "telephone_number": "478-934-0030",
            "fax_number": "478-783-3730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1811 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304748921",
            "country_code": "US",
            "telephone_number": "912-537-0614",
            "fax_number": "912-537-0617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1811 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304748921",
            "country_code": "US",
            "telephone_number": "912-537-0614",
            "fax_number": "912-537-0617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STILL",
        "first_name": "ODELL",
        "middle_name": "P.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-20",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "37085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000539624O",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cochran, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.