Individual provider Active NPI

Odis Brandon Owen, CRNA

  • Certified Registered Nurse Anesthetist
  • Birmingham, AL
National Provider Identifier
1366866949
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1099421 Issued in AL
Practice address
212 Stoneriver Dr
Birmingham, AL 35211-4550
Phone
(205) 253-9225
NPI assigned
Feb 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1099421 AL Primary
Certified Registered Nurse Anesthetist 367500000X 2290823 MA

Addresses

Primary practice location

212 Stoneriver Dr
Birmingham, AL 35211-4550

Mailing address

212 Stoneriver Dr
Birmingham, AL 35211-4550
Phone (205) 253-9225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161003001478 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133343973 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

1 Medical Park Dr
Suite a
Chester, SC 29706-9769
Phone (803) 581-2002

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1099421ALMDCertified Registered Nurse Anesthetist
2290823MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Oct 1, 2023 Accepting new patients
Musc Community Physicians CurrentSince Oct 1, 2023 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 30, 2017 Accepting new patients
Musc Community Physicians Current Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1 Medical Park Dr
Bldg 3
Chester, SC 29706
Phone (803) 385-5000

2001 Laurel St
Ste 300
Columbia, SC 29204
Phone (803) 254-2786

2435 Forest Dr
Columbia, SC 29204
Phone (770) 874-6859

120 Gateway Corporate Blvd
Columbia, SC 29203
Phone (803) 256-5320

109 Blarney Dr
Columbia, SC 29223
Phone (803) 865-8200

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

Organizations & group practices 4

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 1

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": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1366866949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 STONERIVER DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352114550",
            "telephone_number": "205-253-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 STONERIVER DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352114550",
            "telephone_number": "205-253-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "ODIS",
        "middle_name": "BRANDON",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-18",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1099421",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "2290823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; 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.