Jodi Oldfather, Crna LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

JODI OLDFATHER, CRNA LLC

Practice address

82 Puuhonu PL Ste 100
Hilo, HI 96720-2010

Phone

(808) 969-9669

NPI assigned

Jun 10, 2025

Last updated

Sep 26, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jodi Oldfather, CRNANPI 1942572409

Title

Owner

Phone

(808) 282-5317

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jodi Moonbeam Oldfather, CRNA

  • Certified Registered Nurse Anesthetist
  • Oakland, CA
  • NPI 1942572409

  HI

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1063307080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 PILIALOHA ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201865",
            "telephone_number": "808-282-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 PUUHONU PL STE 100",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202010",
            "telephone_number": "808-969-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JODI OLDFATHER, CRNA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "OLDFATHER",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-282-5317",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Hilo, HI
• Providers in Hilo, HI by specialty
• Ambulatory Surgical Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; 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.

Verify at the official NPI Registry.