Active NPI
George Odembo
- Social Worker
- Shelby, NC
National Provider Identifier
1982937967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 213 Patton Dr Ste C
Shelby, NC 28150-4674 - Phone
- (704) 487-4440
- Fax
- (704) 487-1511
- NPI assigned
- Sep 9, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
213 Patton Dr Ste C
Shelby, NC 28150-4674
Mailing address
213 Patton Drive, Suite C.
Shelby, NC 28150-4696
Phone (704) 487-4440
Other practice location 1
1429 N Lafayette St
Shelby, NC 28150-3406
Phone (704) 473-6343
Other practice location 2
213 Patton Dr Ste C
Shelby, NC 28150-4674
Phone (704) 487-4440
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 251C00000X | Other | NC | 251C00000X TAXONOMY |
| 251B00000X | Other | NC | 251B00000X TAXONOMY |
| 251S00000X | Other | NC | 251S00000X TAXONOMY |
| 1255640165 | Other | NC | NPPES NPI |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757635200000",
"number": "1982937967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 PATTON DRIVE, SUITE C.",
"city": "SHELBY",
"state": "NC",
"postal_code": "281504696",
"telephone_number": "704-487-4440",
"fax_number": "704-487-1511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 PATTON DR STE C",
"city": "SHELBY",
"state": "NC",
"postal_code": "281504674",
"telephone_number": "704-487-4440",
"fax_number": "704-487-1511"
}
],
"practiceLocations": [
{
"address_1": "1429 N Lafayette St",
"address_purpose": "LOCATION",
"city": "Shelby",
"state": "NC",
"postal_code": "281503406",
"country_code": "US",
"telephone_number": "704-473-6343",
"fax_number": "704-487-1511",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "213 Patton Dr Ste C",
"address_purpose": "LOCATION",
"city": "Shelby",
"state": "NC",
"postal_code": "281504674",
"country_code": "US",
"telephone_number": "704-487-4440",
"fax_number": "704-487-1511",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ODEMBO",
"first_name": "GEORGE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-09",
"last_updated": "2025-09-12",
"certification_date": "2020-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "251C00000X TAXONOMY",
"identifier": "251C00000X",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "251B00000X TAXONOMY",
"identifier": "251B00000X",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "251S00000X TAXONOMY",
"identifier": "251S00000X",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPPES NPI",
"identifier": "1255640165",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelby, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.