Active NPI
Anya Vinette Green-Odlum, PA-C
- Physician Assistant
- Durham, NC
National Provider Identifier
1891947891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001001561
- Practice address
- 2100 Erwin Rd
Durham, NC 27705-3941 - Phone
- (919) 684-6721
- NPI assigned
- Oct 21, 2008
- Sex
- Female
- 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 | 001001561 | NC | Primary |
Addresses
Primary practice location
2100 Erwin Rd
Durham, NC 27705-3941
Mailing address
1617 Snowmass Way
Durham, NC 27713-4514
Phone (510) 967-8078
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4041 Ed Dr
Raleigh, NC 27612-8004
Phone (919) 324-3385
4041 Ed Dr
Suite 108
Raleigh, NC 27612-8092
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001001561 | NC | MD | Physician Assistant |
Organizations & group practices 1
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.
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- Raleigh, NC
- NPI 1457519514
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224547200000",
"number": "1891947891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1617 SNOWMASS WAY",
"city": "DURHAM",
"state": "NC",
"postal_code": "277134514",
"telephone_number": "510-967-8078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 ERWIN RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277053941",
"telephone_number": "919-684-6721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN-ODLUM",
"first_name": "ANYA",
"middle_name": "VINETTE",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-21",
"last_updated": "2008-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "001001561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.