Individual provider Active NPI

Jona Odim, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • McKinney, TX
National Provider Identifier
1982422952
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2024059804 Issued in TX
Practice address
1400 N Coit Rd Ste 202
McKinney, TX 75071-6656
Phone
(469) 949-4941
Fax
(469) 942-9252
NPI assigned
Sep 30, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2024059804 TX Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 84777 NM

Addresses

Primary practice location

1400 N Coit Rd Ste 202
McKinney, TX 75071-6656

Mailing address

1400 N Coit Rd Ste 202
McKinney, TX 75071-6656
Phone (469) 949-4941

Other practice location 1

6300 Riverside Plaza Ln NW Ste 100
Albuquerque, NM 87120-1908
Phone (505) 456-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250722002948 TX Practitioner - Nurse Practitioner 9931615374 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
84777NMMDPsychiatric/Mental Health Nurse Practitioner
2024059804TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dream Revival Psychiatry Single Specialty CurrentSince May 12, 2025 Accepting new patients

Locations

1400 N Coit Rd
Ste 202
McKinney, TX 75071
Phone (469) 949-4941

1201 S Sherman St
Ste 213
Richardson, TX 75081
Phone (214) 935-8303

1318 E Belt Line Rd
Richardson, TX 75081
Phone (903) 776-4814

Interoperability endpoints

  • Direct secure messaging: jona.odim.1@24846.direct.athenahealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1982422952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N COIT RD STE 202",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750716656",
            "telephone_number": "469-949-4941",
            "fax_number": "469-942-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N COIT RD STE 202",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750716656",
            "telephone_number": "469-949-4941",
            "fax_number": "469-942-9252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6300 Riverside Plaza Ln NW Ste 100",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871201908",
            "country_code": "US",
            "telephone_number": "505-456-0400",
            "fax_number": "833-913-2523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODIM",
        "first_name": "JONA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-30",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "2024059804",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "84777",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.