NPIMap

Individual provider Active NPI

Catherine Re'Nae Odom, ARNP-BC, FNP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1740526649
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9190635 Issued in FL
Practice address
13500 Sutton Park Drive South
Suite 403
Jacksonville, FL 32224-5291
Phone
(904) 493-3390
Fax
(904) 493-3395
NPI assigned
Dec 20, 2012
Last updated
Apr 10, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9190635 FL Primary

Addresses

Primary practice location

13500 Sutton Park Drive South
Suite 403
Jacksonville, FL 32224-5291

Mailing address

13500 Sutton Park Drive South
Suite 403
Jacksonville, FL 32224-5291
Phone (904) 493-3390

Other identifiers 3

IdentifierTypeStateIssuer
GW733YOtherFLMEDICARE - INDIVIDUAL
45681OtherFLMEDICARE - GROUP
Y0FX6OtherFLFLORIDA BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130125000314 FL Practitioner - Nurse Practitioner 6709030844 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Rmed LLCGroup PAC ID 6608768411, 25 clinicians
Primary Care Solutions Jacksonville LLCGroup PAC ID 9739553207, 13 clinicians

Practice addresses (Care Compare)

Jacksonville, FL 32256
Phone (813) 517-0137

42 Davin CT
Ponte Vedra Beach, FL 32082-1840
Phone (904) 490-0264

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Central Florida PLLC CurrentSince Apr 18, 2022 Accepting new patients
Cardiac Vision LLC CurrentSince Apr 1, 2021 Accepting new patients
Mobile Visiting Practitioners, LLC CurrentSince Apr 1, 2021 Accepting new patients
Primary Care Solutions Jacksonville LLC CurrentSince Mar 2, 2023 Accepting new patients
Behavioral Health Services of Florida LLC CurrentSince Sep 15, 2021 Accepting new patients
Cisca Pulmonary Critical Care Inc PastSince Oct 26, 2012 Accepting new patients
VMD Primary Providers Central Florida PLLC PastSince May 8, 2022 Accepting new patients
Symphony Specialty Group, LLC PastSince Jul 17, 2023 Accepting new patients
Jacksonville Hospitalists PA PastSince Feb 1, 2001 Accepting new patients

Locations

4404 S Highway 27
Clermont, FL 34711

140 S Beach St
Ste 202
Daytona Beach, FL 32114
Phone (888) 506-8836

6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202

7807 Baymeadows Rd E
Ste 209
Jacksonville, FL 32256
Phone (904) 231-1204

210 Southern Breeze Dr
Minneola, FL 34715

1060 Woodcock Rd
Ste 128
Orlando, FL 32803
Phone (346) 980-2725

5601 N Hiawassee Rd
Orlando, FL 32818
Phone (321) 294-0611

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHIDAD

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1740526649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 SUTTON PARK DRIVE SOUTH",
            "address_2": "SUITE 403",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322245291",
            "telephone_number": "904-493-3390",
            "fax_number": "904-493-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 SUTTON PARK DRIVE SOUTH",
            "address_2": "SUITE 403",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322245291",
            "telephone_number": "904-493-3390",
            "fax_number": "904-493-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "CATHERINE",
        "middle_name": "RE'NAE",
        "credential": "ARNP-BC, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-20",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9190635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - INDIVIDUAL",
            "identifier": "GW733Y",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - GROUP",
            "identifier": "45681",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "Y0FX6",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.