Odyssey Family Practice
NPI 1780142042 · Family Medicine Physician · Kenai, AK
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Odyssey Family Practice is a Family Medicine Physician organization in Kenai, AK (NPI 1780142042).
Provider details
- NPI number
- 1780142042
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jared Wallace, Owner(907) 313-4569
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Occupational Medicine Clinic/Center261QX0100X
Ambulatory Health Care Facilities
- Clinical Medical Laboratory291U00000X
Laboratories
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-03-06
- Last updated
- 2025-12-01
- Certified
- 2025-12-01
Frequently asked questions
- What is Odyssey Family Practice's NPI number?
- Odyssey Family Practice's National Provider Identifier (NPI) is 1780142042, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Odyssey Family Practice?
- Odyssey Family Practice is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Odyssey Family Practice located?
- Odyssey Family Practice's practice location on file with NPPES is 11595 Kenai Spur Highway, Kenai, AK 99611.
- What is Odyssey Family Practice's phone number?
- The practice phone number listed in the NPPES registry for Odyssey Family Practice is (907) 313-4569.
- Does Odyssey Family Practice accept Medicare?
- Odyssey Family Practice is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Odyssey Family Practice?
- The authorized official listed on Odyssey Family Practice's NPPES record is Jared Wallace, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Odyssey Family Practice's NPI active?
- Yes — Odyssey Family Practice's NPI (1780142042) is active in the NPPES registry as of the last update on 2025-12-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.