Richard D. Odom, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

812 Issued in TX

Practice address

1670 Clairmont Rd
Decatur, GA 30033-4004

Phone

(404) 321-6111

NPI assigned

Mar 30, 2006

Last updated

Oct 9, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1841251790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334004",
            "telephone_number": "404-321-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334004",
            "telephone_number": "404-321-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "RICHARD",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "480030644",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "86J274",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "1215584-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215584-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Odili Odimgbe, RRT
• Gege Odion, O.D.
• Odiorne Dialysis LLC (Chapel Woods Dialysis)
• Alyssa Marie Odom, AU.D.
• Lakenya Odom
• Olubukola Odujebe, FNP-BC
• Chukwukanene Ofiaeli, MD
• Vernique E Ofili, LMSW
• Grace Ofori, RN
• Francisca Ogbonna, DNP, FNP, PMHNP

• Podiatrist in Decatur, GA
• Providers in Decatur, GA by specialty
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.