CAROL MICHELLE ODOM PMHNP-BC
NPI 1699358713
Nurse Practitioner - Psychiatric/Mental Health in Middletown, CT

Active since May 05, 2021PECOS EnrolledAccepts Medicare Assignment
675 MAIN ST, MIDDLETOWN, CT 06457(860) 347-6971 Get Directions Write a Review

NPPES record last updated: August 13, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 13, 2021, May 5, 2021 (2 updates tracked since 2021).

About Carol Michelle Odom Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAROL MICHELLE ODOM PMHNP-BC (NPI 1699358713) is an individual psychiatric/mental health provider in Middletown, Connecticut, licensed in Connecticut (9862) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Briarwood, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1699358713
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameCAROL MICHELLE ODOMCredential: PMHNP-BC
Location Address675 MAIN STMiddletown, CT 06457-2732
Mailing Address675 Main StMiddletown, CT 06457-2732 · (860) 347-6971
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMay 5, 2021
Last NPPES UpdateAugust 13, 20212 updates tracked since enumeration
NPPES CertifiedAugust 13, 2021
NPI 1699358713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses Licensed in CT · 9862 Licensed in NY · F403467
675 MAIN ST, Middletown, CT 06457

Secondary Practice Location 1

Location 18570 148th StBriarwood, NY 11435-2832 · Phone (718) 674-8000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Carol Michelle Odom Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860890746
PECOS Enrollment IDI20240502001133
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06457 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Federally Qualified Health Center (FQHC))
675 MAIN ST
MIDDLETOWN, CT 06457
Social Worker (Clinical)
675 MAIN ST
MIDDLETOWN, CT 06457
Family Medicine
675 MAIN ST
MIDDLETOWN, CT 06457
Psychologist (Clinical)
675 MAIN ST
MIDDLETOWN, CT 06457
Social Worker (Clinical)
675 MAIN ST
MIDDLETOWN, CT 06457
Counselor (Professional)
675 MAIN ST
MIDDLETOWN, CT 06457
Nurse Practitioner (Family)
675 MAIN ST
MIDDLETOWN, CT 06457
Social Worker (Clinical)
675 MAIN ST
MIDDLETOWN, CT 06457

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1699358713, enumerated as an "individual" on May 05, 2021.

The provider is located at 675 MAIN ST MIDDLETOWN, CT 06457 and the phone number is (860) 347-6971.

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.