Active NPI
Harrell Odom II, M.D.
- Cardiovascular Disease Physician
- Nashville, TN
National Provider Identifier
1932102001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 18412
- Practice address
- 222 22ND Ave N
Ste 400
Nashville, TN 37203-1831 - Phone
- (615) 329-5144
- Fax
- (615) 284-2751
- NPI assigned
- May 23, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 18412 | TN | |
| Interventional Cardiology Physician | 207RI0011X | 18412 | TN | |
| Cardiovascular Disease Physician | 207RC0000X | 18412 | TN | Primary |
Addresses
Primary practice location
222 22ND Ave N
Ste 400
Nashville, TN 37203-1831
Mailing address
222 22ND Ave N
Ste 400
Nashville, TN 37203-1831
Phone (615) 329-5144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3074482 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18412 | TN | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-State Cardiology Associates, P.C. | Specialist | Past | Accepting new patients |
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.
-
- Specialist
- Nashville, TN
- NPI 1740276450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1932102001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 22ND AVE N",
"address_2": "STE 400",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372031831",
"telephone_number": "615-329-5144",
"fax_number": "615-284-2751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 22ND AVE N",
"address_2": "STE 400",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372031831",
"telephone_number": "615-329-5144",
"fax_number": "615-284-2751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODOM",
"first_name": "HARRELL",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-23",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TN",
"license": "18412",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "TN",
"license": "18412",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TN",
"license": "18412",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3074482",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.