Deborah Nicole Odum Bryant, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

305783 Issued in LA

Practice address

8000 W Judge Perez Dr
Chalmette, LA 70043-1668

Phone

(504) 826-9500

NPI assigned

Jul 10, 2017

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

Other identifiers 1

Other names 1

• Deborah Nicole Odum Former name

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dodum554501@direct.ochsner.org

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.

• Our Lady of the Lake Physician Group LLC

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1033494943
  Medicare reassignment Care Compare group
• Acs Primary Care Physicians Louisiana PC

  • Emergency Medicine Physician
  • Alexandria, LA
  • NPI 1306889092

  Physician Assistant

  Medicare reassignment NPD
• C & M Medical Services, Inc.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Metairie, LA
  • NPI 1710903059
  Medicare reassignment
• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1164422630
  Medicare reassignment
• East Baton Rouge Emergency Physicians Group, LLC

  • Emergency Medicine Physician
  • Zachary, LA
  • NPI 1255894952
  Medicare reassignment
• Lake Urgent Care Ascension LLC

  • Urgent Care Clinic/Center
  • Prairieville, LA
  • NPI 1912243122
  Medicare reassignment
• St. Bernard Emergency Group, LLC

  • Emergency Medicine Physician
  • Chalmette, LA
  • NPI 1306386685
  Medicare reassignment
• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Hammond, LA
  • NPI 1225119225
  NPD
• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1295986438
  NPD
• Lake Urgent Care Ascension LLC

  • Urgent Care Clinic/Center
  • Gonzales, LA
  • NPI 1477899656
  NPD
• Lake Urgent Care Ascension LLC

  • Urgent Care Clinic/Center
  • Saint Amant, LA
  • NPI 1487024618
  NPD
• Our Lady of the Lake Physician Group LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baton Rouge, LA
  • NPI 1235912502
  NPD

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

• Our Lady of the Lake Hospital Inc.

  • General Acute Care Hospital
  • Baton Rouge, LA
  • NPI 1366436123
  Care Compare affiliation

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1679095863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 W JUDGE PEREZ DR",
            "city": "CHALMETTE",
            "state": "LA",
            "postal_code": "700431668",
            "telephone_number": "504-826-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6300 Main St",
            "address_purpose": "LOCATION",
            "city": "Zachary",
            "state": "LA",
            "postal_code": "707914037",
            "country_code": "US",
            "telephone_number": "225-658-4591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 N Foster Dr",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708061818",
            "country_code": "US",
            "telephone_number": "225-987-9084",
            "fax_number": "225-987-9096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5439 Airline Hwy",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708051712",
            "country_code": "US",
            "telephone_number": "225-358-4853",
            "fax_number": "225-358-2350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODUM BRYANT",
        "first_name": "DEBORAH",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "305783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2449583",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "ODUM",
            "middle_name": "NICOLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Chalmette, LA
• Providers in Chalmette, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.