Active NPI
Anna Elise Odom, PH.D.
- Psychologist
- White Plains, NY
National Provider Identifier
1942492186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 016849
- Practice address
- 21 Bloomingdale Rd
White Plains, NY 10605-1504 - Phone
- (646) 734-3697
- NPI assigned
- Aug 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 016849 | NY | Primary |
Addresses
Primary practice location
21 Bloomingdale Rd
White Plains, NY 10605-1504
Mailing address
145 E 84TH St Apt 2D
New York, NY 10028-2072
Phone (646) 734-3697
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180201003098 | NY | Order and Referring Only - Clinical Psychologist | 2163782525 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392336000000",
"number": "1942492186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 E 84TH ST APT 2D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100282072",
"telephone_number": "646-734-3697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 BLOOMINGDALE RD",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106051504",
"telephone_number": "646-734-3697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODOM",
"first_name": "ANNA",
"middle_name": "ELISE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-12",
"last_updated": "2014-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "016849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Plains, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.