Individual provider Active NPI

Melissa Christine Odom, ARNP

  • Family Nurse Practitioner
  • Oviedo, FL
National Provider Identifier
1932619004
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9207044 Issued in FL
Practice address
2200 Winter Springs Blvd. # 106-265
Oviedo, FL 32765
Phone
(407) 973-0599
Fax
(407) 957-0835
NPI assigned
Oct 3, 2017
Last updated
May 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9207044 FL Primary

Addresses

Primary practice location

2200 Winter Springs Blvd. # 106-265
Oviedo, FL 32765

Mailing address

2200 Winter Springs Blvd. # 106-265
Oviedo, FL 32765
Phone (407) 634-2104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Oct 1, 2024 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9207044FLMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: melissa.odom@380638208327684.direct.elationemr.com
  • Direct secure messaging: melissa.odom@750298948173828.direct.elationemr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1932619004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 WINTER SPRINGS BLVD. # 106-265",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "32765",
            "telephone_number": "407-634-2104",
            "fax_number": "407-550-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WINTER SPRINGS BLVD. # 106-265",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "32765",
            "telephone_number": "407-973-0599",
            "fax_number": "407-957-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "MELISSA",
        "middle_name": "CHRISTINE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9207044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

Verify at the official NPI Registry.