Individual provider Active NPI

Jarred Odor

  • Certified Registered Nurse Anesthetist
  • Portland, ME
National Provider Identifier
1154989630
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
086213-23 Issued in NH
Practice address
716 Stevens Ave
Portland, ME 04103-2693
Phone
(207) 221-4516
NPI assigned
May 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Certified Registered Nurse Anesthetist 367500000X 086213-23 NH Primary

Addresses

Primary practice location

716 Stevens Ave
Portland, ME 04103-2693

Mailing address

19 Bayview Drive
Eliot, ME 03903
Phone (207) 608-1901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211115002236 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163811043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portsmouth Anesthesia Associates PAGroup PAC ID 6002855327, 40 clinicians

Practice addresses (Care Compare)

333 Borthwick Ave
Portsmouth, NH 03801-7128
Phone (603) 436-5110

8 Prospect St
Nashua, NH 03060-3925
Phone (603) 577-2000

Hospital & facility affiliations

  • Portsmouth Regional Hospital Hospital, Portsmouth, NH, CCN 300029
  • Frisbie Memorial Hospital Hospital, Rochester, NH, CCN 300014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Portsmouth Anesthesia Associates PA CurrentSince Aug 14, 2021 Accepting new patients
Hospitalist Medicine Physicians of New York - Patchogue PC CurrentSince Feb 8, 2024 Accepting new patients

Locations

10 Prospect St
Ste 101
Nashua, NH 03060
Phone (603) 578-9909

8 Prospect St
Nashua, NH 03060
Phone (603) 281-9275

333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1154989630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BAYVIEW DRIVE",
            "city": "ELIOT",
            "state": "ME",
            "postal_code": "03903",
            "telephone_number": "207-608-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032693",
            "telephone_number": "207-221-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOR",
        "first_name": "JARRED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "086213-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.