Mrs Courtney Chavis Odom, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Mc Coll, South Carolina. She graduated from nursing school in 2021 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Caresouth Carolina Inc. and her current practice location is
3080 Highway 15-401 E, Mc Coll, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(843) 523-5751.
Mrs Courtney Chavis Odom is licensed to practice in South Carolina (license number 25309) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1962095612.
Provider's Profile
| Full Name | Mrs Courtney Chavis Odom |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 3 Years |
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| Location | 3080 Highway 15-401 E, Mc Coll, South Carolina |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Courtney Chavis Odom graduated from nursing school in 2021
NPI Data:
- NPI Number: 1962095612
- Provider Enumeration Date: 02/13/2021
- Last Update Date: 03/09/2023
Medicare PECOS Information:
- PECOS PAC ID: 8426447376
- Enrollment ID: I20220610001856
Medical Identifiers
Medical identifiers for Mrs Courtney Chavis Odom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962095612 | NPI | - | NPPES |
| NP8401 | Medicaid | SC | |
| SCM901 | Other | SC | MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 225769 (South Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 5015042 (North Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 25309 (South Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Caresouth Carolina Inc. | 1052221314 | 46 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Courtney Chavis Odom allows following entities to bill medicare on her behalf.
| Entity Name | Caresouth Carolina Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1720082571
PECOS PAC ID: 1052221314
Enrollment ID: O20040511000280 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Courtney Chavis Odom is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mrs Courtney Chavis Odom, FNP-C
Po Box 1090,
Hartsville, SC 29551-1090
Ph: (843) 857-0111 | Mrs Courtney Chavis Odom, FNP-C
3080 Highway 15-401 E,
Mc Coll, SC 29570-6128
Ph: (843) 523-5751 |
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