Individual provider Active NPI

Brittany Kalisse Odom, M.D.

  • Pediatrics Physician
  • West Point, MS
National Provider Identifier
1972965689
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
33590 Issued in MS
Practice address
63 Medical Center Dr
West Point, MS 39773-0430
Phone
(662) 494-1620
Fax
(662) 494-0375
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-152382 IL
Pediatrics Physician 208000000X MD2022-0892 NM
Pediatrics Physician 208000000X 33590 MS Primary

Addresses

Primary practice location

63 Medical Center Dr
West Point, MS 39773-0430

Mailing address

63 Medical Center Dr
West Point, MS 39773-0430
Phone (662) 494-1620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, MS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220822000441 NM Practitioner - Pediatric Medicine 2163843079 Reassigns benefits to 1 organization
I20240802001169 MS Practitioner - Pediatric Medicine 2163843079 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-152382ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de Familia, Incorporated CurrentSince Aug 8, 2022 Accepting new patients
Clay County Medical Corporation Current Accepting new patients
La Clinica de Familia, Incorporated CurrentSince Aug 8, 2022 Accepting new patients
Clay County Medical Corporation CurrentSince Jul 23, 2024 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
La Clinica de Familia, Incorporated Current Accepting new patients
Clay County Medical Corporation Current Accepting new patients
Clay County Medical Corporation CurrentSince Jul 23, 2024 Accepting new patients
Clay County Medical Corporation Past Accepting new patients

Locations

808 Varsity Dr
Tupelo, MS 38801
Phone (662) 377-2386

63 Medical Center Dr
West Point, MS 39773
Phone (662) 494-1620

150 Medical Center Dr
West Point, MS 39773
Phone (601) 494-2321

826 Anthony Dr
Anthony, NM 88021
Phone (575) 201-5135

385 Calle de Alegra
Bldg C
Las Cruces, NM 88005
Phone (575) 521-7181

385 Calle de Alegra
Bldg A
Las Cruces, NM 88005
Phone 57552611052444

385 Calle de Alegra
Bldg B
Las Cruces, NM 88005
Phone (575) 532-2044

Interoperability endpoints

  • Direct secure messaging: brittanyodom@nmhs.medalliesdirect.net

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1972965689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MEDICAL CENTER DR",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "397730430",
            "telephone_number": "662-494-1620",
            "fax_number": "662-494-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MEDICAL CENTER DR",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "397730430",
            "telephone_number": "662-494-1620",
            "fax_number": "662-494-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "BRITTANY",
        "middle_name": "KALISSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-152382",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2022-0892",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "33590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Point, MS

Sources for this page

Verify at the official NPI Registry.