Kathleen Suzanne Odell, CRNP-FAMILY

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R128442 Issued in MD

Practice address

1017 E Baltimore St
Baltimore, MD 21202-4705

Phone

(410) 675-7500

Fax

(443) 230-0059

NPI assigned

Nov 29, 2017

Last updated

Nov 29, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Health Alliance Associates, Inc.

  • General Practice Physician
  • Baltimore, MD
  • NPI 1437549466
  Medicare reassignment NPD

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1104330109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 103",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211460103",
            "telephone_number": "410-675-7500",
            "fax_number": "443-230-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 E BALTIMORE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024705",
            "telephone_number": "410-675-7500",
            "fax_number": "443-230-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELL",
        "first_name": "KATHLEEN",
        "middle_name": "SUZANNE",
        "credential": "CRNP-FAMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R128442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Oddis
• Oreoluwa Adedoyin Odebode, BSN, RN
• Kamayani Odegard, LCSW-C
• Nour Basem Kamel Odeh, MBBS
• Andrea Odell, LCSW-C
• Stephanie Odenigbo
• Patience Ifeyinka Odeniyide, MD
• John Odenwald
• Maricia Odeyemi
• Joan Odiaka

• Family Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.