Raven Odoms, RT

Primary specialty

Radiography Radiologic TechnologistTaxonomy code 2471C3402X

License

92475 Issued in TX

Practice address

280 Highway 418 E
Silsbee, TX 77656-3729

Phone

(409) 386-1200

Fax

(409) 386-1219

NPI assigned

Sep 12, 2018

Last updated

Sep 12, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Silsbee Family Medicine, PA

  • Primary Care Clinic/Center
  • Silsbee, TX
  • NPI 1700075108
  NPD (past)

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1831672096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 HIGHWAY 418 E",
            "city": "SILSBEE",
            "state": "TX",
            "postal_code": "776563729",
            "telephone_number": "409-386-1200",
            "fax_number": "409-386-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 HIGHWAY 418 E",
            "city": "SILSBEE",
            "state": "TX",
            "postal_code": "776563729",
            "telephone_number": "409-386-1200",
            "fax_number": "409-386-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOMS",
        "first_name": "RAVEN",
        "credential": "RT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "TX",
            "license": "92475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adaeze Ndu
• Edward A Neusel, DDS
• Joseph Adam Newell, FNP-C
• Hannah Katherine Newlon, OTR/L
• Oakbend Medical Center (Paradigm at the Pines)
• Joan Ijeoma Okwara, PHARMD
• Rheala S Parker, NP
• Chintan Patel
• Scott Paulino, P.T.
• Natalie Peveto, D.C.

• Radiography Radiologic Technologist in Silsbee, TX
• Providers in Silsbee, TX by specialty
• Radiography Radiologic Technologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; 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.