Active NPI
Michael Sean O'Dell, CRNA
- Certified Registered Nurse Anesthetist
- Oklahoma City, OK
National Provider Identifier
1013284397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R0067052
- Practice address
- 5501 N Portland Ave
Oklahoma City, OK 73112-2074 - Phone
- (405) 604-6000
- NPI assigned
- Nov 30, 2011
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R0067052 | OK | Primary |
Addresses
Primary practice location
5501 N Portland Ave
Oklahoma City, OK 73112-2074
Mailing address
PO Box 248875
Oklahoma City, OK 73124-8875
Phone (918) 392-2944
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200421920A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0067052 | OK | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Regents of the University of Oklahoma - Ou Physicians | Current | Accepting new patients | |
| Ou Health Partners, Inc | Current | Accepting new patients | |
| Board of Regents of the University of Oklahoma - Ou Physicians | Current | Accepting new patients | |
| Ou Health Partners, Inc | Current | Accepting new patients |
Locations
825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864
900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Oklahoma City, OK
- NPI 1801869250
-
- Multi-Specialty Clinic/Center
- Oklahoma City, OK
- NPI 1528642642
-
- Multi-Specialty Clinic/Center
- Edmond, OK
- NPI 1124646971
-
- Prosthetic/Orthotic Supplier
- Oklahoma City, OK
- NPI 1447834460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391040000000",
"number": "1013284397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 248875",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731248875",
"telephone_number": "918-392-2944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5501 N PORTLAND AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731122074",
"telephone_number": "405-604-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'DELL",
"first_name": "MICHAEL",
"middle_name": "SEAN",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-30",
"last_updated": "2014-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OK",
"license": "R0067052",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200421920A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.