Elizabeth Boyd Odom, RD, LDN
Individual provider Active NPI Metabolic Nutrition Registered Dietitian · Halifax, NC
NPI 1700190832 · NPPES record last updated Apr 9, 2014
Key facts
- NPI
- 1700190832
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Metabolic Nutrition Registered Dietitian 133VN1006X
- License
- 843319 (NC)
- Practice address
- 19 North Dobbs Street
Halifax, NC 27839-0010 - Phone
- (252) 583-5021
- Fax
- (252) 583-2975
- NPI assigned
- Jul 30, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 843319 | NC | MD | Metabolic Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Halifax County Health Department | Nutrition, Metabolic | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | L001680 | NC | |
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 843319 | NC | Yes |
Addresses
Primary practice location
19 North Dobbs Street
Halifax, NC 27839-0010
Mailing address
19 North Dobbs Street
Halifax, NC 27839-0010
Phone (252) 583-5021
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3404433 | Medicaid | NC | |
| 340432 | Medicaid | NC | |
| 6005545 | Medicaid | NC |
Other providers in Halifax, NC
- Halifax County Health Department
- Halifax County Schools
- Life, Inc.
- Lighthouse Transportation LLC
- Janice Tillery Myrick
- Diane Rokita Pridgen
- Brandi N Ross
- Rural Health Group Inc
- Rural Health Group Inc
- Rural Health Group Inc
All providers in Halifax, NC · Metabolic Nutrition Registered Dietitian in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.