Individual provider Active NPI

Sharon Denise Odom, CRNA

  • Certified Registered Nurse Anesthetist
  • Tulsa, OK
National Provider Identifier
1396074381
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
81091 Issued in OK
Practice address
6839 S Canton Ave
Tulsa, OK 74136-3402
Phone
(918) 494-0612
NPI assigned
Dec 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R 0081091 OK
Certified Registered Nurse Anesthetist 367500000X R 0081091 OK
Certified Registered Nurse Anesthetist 367500000X 81091 OK Primary

Addresses

Primary practice location

6839 S Canton Ave
Tulsa, OK 74136-3402

Mailing address

14350 N 106TH East Ave
Collinsville, OK 74021-3755
Phone (918) 519-7224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100514000300 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709914534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh Aai PLLCGroup PAC ID 4587818729, 73 clinicians
Associated Anesthesiologists, Inc.Group PAC ID 7911989017, 111 clinicians

Practice addresses (Care Compare)

6839 S Canton Ave
Tulsa, OK 74136-3402
Phone (918) 494-0612

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R 0081091OKMDRegistered Nurse
81091OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Osh Aai PLLC CurrentSince Jan 26, 2013 Accepting new patients

Locations

6839 S Canton Ave
Tulsa, OK 74136
Phone (918) 494-0612

2408 E 81st St
Ste 900
Tulsa, OK 74137
Phone (918) 477-5000

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": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1396074381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14350 N 106TH EAST AVE",
            "city": "COLLINSVILLE",
            "state": "OK",
            "postal_code": "740213755",
            "telephone_number": "918-519-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6839 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363402",
            "telephone_number": "918-494-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "SHARON",
        "middle_name": "DENISE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-22",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R 0081091",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "R 0081091",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "81091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.