Benjamin Odom, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1-142308 Issued in AL

Practice address

3104 Blue Lake Dr Ste 110
Vestavia, AL 35243-2372

Phone

(205) 977-1949

Fax

(205) 977-1933

NPI assigned

Mar 20, 2020

Sex

Male

Sole proprietor

Yes

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 GA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Care Anesthesia Partners LLCGroup PAC ID 7618212200, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041

Medicare enrollment (NPD)

Enrolled

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.

• Total Care Anesthesia Partners LLC

  • Certified Registered Nurse Anesthetist
  • Demorest, GA
  • NPI 1962985168

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

• Northeast Georgia Medical Center Habersham LLC

  • General Acute Care Hospital
  • Demorest, GA
  • NPI 1740981430
  Care Compare affiliation

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

{
    "created_epoch": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1639705767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 N ELM ST",
            "city": "MOUNT PLEASANT",
            "state": "TN",
            "postal_code": "384741217",
            "telephone_number": "205-441-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 BLUE LAKE DR STE 110",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432372",
            "telephone_number": "205-977-1949",
            "fax_number": "205-977-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "BENJAMIN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-20",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-142308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbie Novak, M.S.,CCC-SLP
• Andrea Flavia Nunes, DMD
• Nutrifocus
• Gretchen Quave O'Rear, OT
• Sherri S Oberding, OTR/L
• Mary Elizabeth Odum, PA
• William James Oldfield, DPT
• Op Orthodontics of Al, LLC
• Julia Oratio
• Orthopaedic Sports Medicine Clinic of Alabama, P.C.

• Certified Registered Nurse Anesthetist in Vestavia, AL
• Providers in Vestavia, AL by specialty
• Certified Registered Nurse Anesthetist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.