Individual provider Active NPI

Patricia A Odham, FNP

  • Family Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1750457024
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5001162 Issued in NC
Practice address
3121 Wrightsville Ave
Wilmington, NC 28403-4111
Phone
(910) 769-6053
Fax
(910) 769-9048
NPI assigned
Nov 28, 2006
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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 5001162 NC Primary

Addresses

Primary practice location

3121 Wrightsville Ave
Wilmington, NC 28403-4111

Mailing address

1000 Medical Center Dr
Wilmington, NC 28401-7353
Phone (910) 970-4673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20071109000131 NC Practitioner - Nurse Practitioner 9234237801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trinity Wellness Center of Wilmington IncGroup PAC ID 6002843752, 14 clinicians

Practice addresses (Care Compare)

7741 Market St
Suite H
Wilmington, NC 28411-9444
Phone (910) 343-8424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5001162NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Place of New Hanover County Inc CurrentSince Nov 12, 2023 Accepting new patients
Trinity Wellness Center of Wilmington Inc CurrentSince Oct 1, 2023 Accepting new patients
Wilmington Family Practice PLLC Family CurrentSince Mar 1, 2021 Accepting new patients

Locations

3971 Business 17 E
Bolivia, NC 28422
Phone (888) 751-3730

1000 Corporate Dr
Ste 301
Hillsborough, NC 27278
Phone (910) 343-8424

1000 Medical Center Dr
Wilmington, NC 28401
Phone (502) 434-1898

1907 S 17th St
Ste 1
Wilmington, NC 28401
Phone (877) 603-6199

201 N Front St
Ste LL102
Wilmington, NC 28401

7741 Market St
Ste H
Wilmington, NC 28411
Phone (910) 343-8424

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1750457024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017353",
            "telephone_number": "910-970-4673",
            "fax_number": "910-970-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 WRIGHTSVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034111",
            "telephone_number": "910-769-6053",
            "fax_number": "910-769-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODHAM",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5001162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.