Casandra Odoms

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5271988 Issued in ID

Practice address

222 N 2ND St Ste 204
Boise, ID 83702-6130

Phone

(208) 429-9100

NPI assigned

Jul 20, 2023

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 ID

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ashley a Davis M.D.P.C.Group PAC ID 0547204695, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Ashley a Davis M.D.P.C.

  • Family Medicine Physician
  • Boise, ID
  • NPI 1306970827
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1205516697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N 2ND ST STE 204",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026130",
            "telephone_number": "208-429-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N 2ND ST STE 204",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026130",
            "telephone_number": "208-429-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOMS",
        "first_name": "CASANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-20",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "5271988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Oconnell
• Monisha Oconnor
• Stephen Odell, CRNA
• Andrew Tyler Odom, BS
• Carl Irwin Odom, MD
• Murry Odonnell
• Meghan Oeding, LAT, ATC
• Richard Keith Oehlschlager, M.D.
• Sarah Ann Oftedal, MOTR/L
• Shelly Marie Ogami, RPH

• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.
• 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.