NPIMap

Organization Active NPI

Aubrey a. Odom, O.D. P.C.

  • Optometrist
  • Evergreen, AL
National Provider Identifier
1699805960
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-860-TA-413 Issued in AL
Legal business name
AUBREY A. ODOM, O.D. P.C.
Practice address
109 S Main St
Evergreen, AL 36401-3320
Phone
(251) 578-2922
Fax
(251) 578-2952
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Aubrey Alan Odom, O.D.
Title
President
Phone
(251) 578-2922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X S-860-TA-413 AL Primary

Addresses

Primary practice location

109 S Main St
Evergreen, AL 36401-3320

Mailing address

109 S Main St
P.O. Box 862
Evergreen, AL 36401-3320
Phone (251) 578-2922

Other names 1

  • Primary Eye Care Doing business as

National Provider Directory

National Provider Directory

Locations

315 S Main St
Evergreen, AL 36401
Phone (251) 578-2922

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699805960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S MAIN ST",
            "address_2": "P.O. BOX 862",
            "city": "EVERGREEN",
            "state": "AL",
            "postal_code": "364013320",
            "telephone_number": "251-578-2922",
            "fax_number": "251-578-2952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S MAIN ST",
            "city": "EVERGREEN",
            "state": "AL",
            "postal_code": "364013320",
            "telephone_number": "251-578-2922",
            "fax_number": "251-578-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUBREY A. ODOM, O.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "AUBREY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-578-2922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-860-TA-413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evergreen, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.