Terry W Odom Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

TERRY W ODOM PEDIATRICS

Practice address

702 Earl Frye Blvd
Amory, MS 38821-9403

Phone

(662) 256-9391

Fax

(662) 256-4307

NPI assigned

Sep 21, 2006

Last updated

Jun 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Terry W Odom, M.D.NPI 1093814980

Title

M.D. -Owner

Phone

(662) 256-9391

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Terry William Odom, M.D.

  • Pediatrics Physician
  • Amory, MS
  • NPI 1093814980
  Authorized official Same address or phone

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1679672497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 EARL FRYE BLVD",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388219403",
            "telephone_number": "662-256-9391",
            "fax_number": "662-256-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 EARL FRYE BLVD",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388219403",
            "telephone_number": "662-256-9391",
            "fax_number": "662-256-4307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY W ODOM PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "M.D. -OWNER",
        "authorized_official_telephone_number": "662-256-9391",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06136862",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steve Randle
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• Diane R. Taylor, CRNP
• Ericka Nycole Taylor, LCSW
• The Respiratory & Diabetes Care Center
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• Abby Tomlin, PT, DPT

• Pediatrics Physician in Amory, MS
• Providers in Amory, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.