Katelyn Odom, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202007497 Issued in VA

Practice address

5301 Providence Rd
Suite 80
Virginia Beach, VA 23464-4128

Phone

(757) 467-1900

Fax

(757) 467-7900

NPI assigned

May 5, 2015

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

• Katelyn Pippin Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 5, 2015.

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1851778393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 PROVIDENCE RD",
            "address_2": "SUITE 80",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644128",
            "telephone_number": "757-467-1900",
            "fax_number": "757-467-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 PROVIDENCE RD",
            "address_2": "SUITE 80",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644128",
            "telephone_number": "757-467-1900",
            "fax_number": "757-467-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "KATELYN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202007497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "PIPPIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Virginia Beach, VA
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.