Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Odom

Individual provider Certified Registered Nurse Anesthetist · NPI 1669216602

Nicole Odom is registered under Certified Registered Nurse Anesthetist (CRNA) in Philadelphia, Pennsylvania. Graduated from University of Utah School of Medicine in 2014, 12 years ago. Practices with Jefferson University Physicians, a 1,554-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
12
Trained at
University of Utah School of Medicine
Licensed in
PA
In the registry since
2024
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Practice location Address checks out

111 S 11th St
Philadelphia, PA 19107-4870
Phone: (215) 955-6000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence RN787676 (PA)

Record details

NPI number1669216602
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 24, 2024
Last updated in NPPESJune 24, 2024
Certification dateJune 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Jefferson University Physicians — 1554 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients35
Services billed 36 a service is one billed item, such as a visit, a test or a procedure
Average patient age72

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Jefferson University Physicians

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 1554 clinicians in the practice; 12 are shown here.

Other providers in Philadelphia