Active NPI
James F Odom, PAC
- Physician Assistant
- Austell, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 005030
- Practice address
- 2041 Mesa Valley Way
Suite 100
Austell, GA 30106-6828 - Phone
- (770) 944-1100
- Fax
- (770) 941-7227
- NPI assigned
- Apr 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005030 | GA | Primary |
Addresses
Primary practice location
2041 Mesa Valley Way
Suite 100
Austell, GA 30106-6828
Mailing address
2041 Mesa Valley Way
Suite 100
Austell, GA 30106-6828
Phone (770) 944-1100
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 898561166G | Medicaid | GA | |
| 898561166H | Medicaid | GA | |
| 898561166F | Medicaid | GA | |
| 898561166I | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2041 Mesa Valley Way
Suite 100
Austell, GA 30106-6856
270 Chastain NWRD
Kennesaw, GA 30144-3012
Phone (770) 421-8005
3698 Largent NW Way
Ste103
Marietta, GA 30064-5923
Phone (678) 354-2883
4441 Atlanta Rd SE
Suite 207
Smyrna, GA 30080-6442
Phone (770) 944-1100
5671 Peachtree Dunwoody Rd
Suite 900
Atlanta, GA 30342-5022
5671 Peachtree Dunwoody Rd NE
Suite 900 950
Atlanta, GA 30342-5022
Phone (404) 847-9999
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005030 | GA | MD | Physician Assistant |
| 6490 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Resurgens, LLC | Current | Accepting new patients | |
| Resurgens, LLC | Current | Accepting new patients | |
| Cotton Ridge Physical Therapy LLC | Past | Accepting new patients | |
| Chatham Orthopaedic Associates, PA | Past | Accepting new patients |
Locations
2041 Mesa Valley Way
Ste 100
Austell, GA 30106
Phone (770) 944-1100
2041 Mesa Valley Way
Austell, GA 30106
Phone (404) 417-1788
6001 Professional Pkwy
Ste 1040
Douglasville, GA 30134
Phone (770) 489-3513
270 Chastain Rd NW
Kennesaw, GA 30144
Phone (678) 594-6080
3698 Largent Way NW
Ste 103
Marietta, GA 30064
Phone (678) 354-2883
5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590
5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732
4441 Atlanta Rd SE
Ste 207
Smyrna, GA 30080
Phone (770) 423-2180
2230 Towne Lake Pkwy
Bldg 300
Woodstock, GA 30189
Phone (770) 517-1900
2230 Towne Lake Pkwy
Ste 100
Woodstock, GA 30189
Phone (770) 591-3511
Interoperability endpoints
- james.odom.1@15749.direct.athenahealth.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Atlanta, GA
- NPI 1386697928
-
- Orthopaedic Surgery Physician
- Braselton, GA
- NPI 1033919790
-
- Orthopaedic Surgery Physician
- Savannah, GA
- NPI 1366495814
-
- Physical Therapist
- Statesboro, GA
- NPI 1013956531
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Austell, GA
- NPI 1467420448
-
- General Acute Care Hospital
- Douglasville, GA
- NPI 1649247974
-
- Long Term Care Hospital
- Marietta, GA
- NPI 1700853041
Long-term care hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305849600000",
"number": "1790901957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2041 MESA VALLEY WAY",
"address_2": "SUITE 100",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301066828",
"telephone_number": "770-944-1100",
"fax_number": "770-941-7227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2041 MESA VALLEY WAY",
"address_2": "SUITE 100",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301066828",
"telephone_number": "770-944-1100",
"fax_number": "770-941-7227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODOM",
"first_name": "JAMES",
"middle_name": "F",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2011-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "005030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "898561166G",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "898561166H",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "898561166F",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "898561166I",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.