McKinley Odom, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12135 Issued in SC

Practice address

1711 Lakeside Ave Ste 5
St Augustine, FL 32084-4103

Phone

(904) 679-3449

NPI assigned

Nov 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, FL2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Augustine Rehabilitation Specialists LLCGroup PAC ID 8426107293, 38 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.48 of 100Reported as group

Quality

86.95

Improvement activities

40

Cost

72.33

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Saint Augustine Rehabilitation Specialists LLC

  • Physical Therapist
  • St Augustine, FL
  • NPI 1548407521
  Medicare reassignment Care Compare group NPD
• Chapin Rehabilitation Clinic, Inc.

  • Physical Therapy Clinic/Center
  • Chapin, SC
  • NPI 1033128160
  Medicare reassignment NPD
• Saint Augustine Rehabilitation Specialists LLC

  • Physical Therapist
  • Saint Augustine, FL
  • NPI 1225813876
  NPD
• Saint Augustine Rehabilitation Specialists LLC

  • Physical Therapist
  • Saint Augustine, FL
  • NPI 1538788617
  NPD
• Chapin Physical Therapy LLC

  • Physical Medicine & Rehabilitation Physician
  • Chapin, SC
  • NPI 1861929473

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1629844089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 SILVERPOINT RD",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290367963",
            "telephone_number": "803-543-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 LAKESIDE AVE STE 5",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320844103",
            "telephone_number": "904-679-3449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 Chapin Rd",
            "address_purpose": "LOCATION",
            "city": "Chapin",
            "state": "SC",
            "postal_code": "29036",
            "country_code": "US",
            "telephone_number": "803-345-3811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODOM",
        "first_name": "MCKINLEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Lorenz Oborne, LMHC
• Oceanside Endodontics OD St. Augustine
• Oceanvibes, Inc.
• Patricia Oconnell, PHYSICAL THERAPIST
• Odalys Brito MD & Associates PA
• Robert A Oesterle, MD
• Enya Ohlenschlager Van Coller, DPT
• Merlin Paul Ohmer, DDS
• William J Oktavec, MD
• Ayoola Waley Olajide, MD

• Physical Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.