Individual provider Active NPI

Kristy L Oden, CRNP

  • Family Nurse Practitioner
  • Sheffield, AL
National Provider Identifier
1073623013
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-094352 Issued in AL
Practice address
1120 S Jackson Hwy Ste 105
Sheffield, AL 35660-5770
Phone
(256) 386-1125
Fax
(888) 745-7084
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-094352 AL Primary

Addresses

Primary practice location

1120 S Jackson Hwy Ste 105
Sheffield, AL 35660-5770

Mailing address

PO Box 11407, Dept# 5839
Birmingham, AL 35246-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051128000668 AL Practitioner - Nurse Practitioner 0648290221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Helen Keller Specialty CareGroup PAC ID 9335676402, 27 clinicians

Practice addresses (Care Compare)

1120 S Jackson Hwy
Suite 105
Sheffield, AL 35660-5770
Phone (256) 386-1125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NW Alabama Practice Management, LLC CurrentSince Jul 18, 2023 Accepting new patients
Helen Keller Specialty Care CurrentSince Nov 1, 2024 Accepting new patients
Desselle Surgical Clinic, LLC Past Accepting new patients

Locations

1300 S Montgomery Ave
Sheffield, AL 35660
Phone (256) 386-4005

1100 S Jackson Hwy
Ste 105
Sheffield, AL 35660
Phone (256) 386-4066

1120 S Jackson Hwy
Sheffield, AL 35660
Phone (256) 386-0855

1100 S Jackson Hwy
Ste 250
Sheffield, AL 35660
Phone (256) 381-6673

1120 S Jackson Hwy
Ste 105
Sheffield, AL 35660
Phone (256) 386-1125

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1073623013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407, DEPT# 5839",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352460001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S JACKSON HWY STE 105",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "356605770",
            "telephone_number": "256-386-1125",
            "fax_number": "888-745-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEN",
        "first_name": "KRISTY",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-094352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheffield, AL

Sources for this page

Verify at the official NPI Registry.