MRS. CARLY M ODESINA (NPI# 1548610959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548610959 |
| Entity Type | Individual |
| Full Name | MRS. CARLY M ODESINA |
| Credential | APRN |
| Practice Address |
270 Main St Portland CT 06480-1836 |
| Mailing Address |
28 Crescent St Middletown CT 06457-3654 |
| Practice Telephone | 8603423392 |
| Practice Fax Number | 8603588658 |
| Mailing Telephone | 8603584820 |
| Mailing Fax Number | 8603588661 |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2018-09-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
12.006642 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008067661 | 05 |
| Street Address |
270 MAIN ST |
| City | PORTLAND |
| State | CT |
| Zip Code | 06480-1836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790023752 | Symmetry Physical Therapy, LLC | Clinic/Center | 270 Main St, Suite B, Portland, CT 06480-1859 | 2013-01-26 |
| 1346536398 | Justin Caskey | Family Medicine | 270 Main St, Portland, CT 06480-1836 | 2011-06-28 |
| 1093028052 | Matthew Nichols | Family Medicine | 270 Main St, Portland, CT 06480-1859 | 2010-07-20 |
| 1710206339 | Jessica A Terrone Roehr | Family Medicine | 270 Main St, Portland, CT 06480-1836 | 2010-05-21 |
| 1639406184 | Wendy Griswold | Nurse Practitioner | 270 Main St, Portland, CT 06480-1857 | 2009-11-04 |
| 1124281613 | Israel Cordero | Family Medicine | 270 Main St, Portland, CT 06480-1859 | 2008-07-07 |
| 1710104625 | Mhs Primary Care | Social Worker | 270 Main St, Portland, CT 06480-1857 | 2007-04-20 |
| 1821119843 | Wendy Ann Tagan Conroy | Nurse Practitioner | 270 Main St, Portland, CT 06480-1859 | 2007-04-03 |
| 1700902210 | Keith Arcari | Physical Therapist | 270 Main St, Suite B, Portland, CT 06480-1859 | 2007-03-22 |
| 1255369419 | George M Rosenfeld | Family Medicine | 270 Main St, Portland, CT 06480-1857 | 2006-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295184638 | Alyssa Rose Unikewicz | Specialist/Technologist | 5 Allison Drive, Portland, CT 06480 | 2016-06-07 |
| 1124168224 | Portland Board of Education | Local Education Agency (LEA) | Portland High School, 95 High Street, Portland, CT 06480 | 2007-02-07 |
| 1699700831 | Stephen P Paschall | Counselor | 44 Marlborough Turnpike, Path, Portland, CT 06480 | 2006-07-12 |
| 1346600368 | Thalody Family Dentistry LLC | Dentist | 260 Main St, Portland, CT 06480 | 2016-03-03 |
| 1669782975 | Ann L Sinko | Marriage & Family Therapist | 264 Main St, Portland, CT 06480 | 2010-10-20 |
| 1013023878 | Richard Brian Morse | Dentist | 322 Main St, Portland, CT 06480 | 2006-08-22 |
| 1811344500 | Karen Pickel | Pharmacist | 35 Wilcox Ln, Portland, CT 06480-1002 | 2016-05-23 |
| 1770520652 | Deborah B. Heilman | Physical Therapist | 25 Wilcox Ln, Portland, CT 06480-1002 | 2006-06-01 |
| 1184644015 | Applied Physical Therapy & Wellness, LLC | Clinic/Center | 25 Wilcox Ln, Portland, CT 06480-1002 | 2006-07-21 |
| 1952964686 | Shane Norman Cardinal | Specialist/Technologist | 521 Glastonbury Tpke, Portland, CT 06480-1003 | 2019-04-18 |
| Find all providers in zip 06480 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822794 | Danielle Langer | Nurse Practitioner | 35 Ridgeview Rd, Portland, CT 06480-4014 | 2020-08-23 |
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1114566650 | Sadie Garnache-poirier | Nurse Practitioner | 65 W Commercial St Ste 107, Portland, ME 04101-4789 | 2020-01-02 |
| 1902441629 | Jennifer Marie Colpitts | Nurse Practitioner | 1600 Congress St Ste B, Portland, ME 04102-2148 | 2019-11-18 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1265081640 | Christina Lee | Nurse Practitioner | 144 State St # 1, Portland, ME 04101-3776 | 2019-09-09 |
| 1407401474 | Abby Christine Vopal | Nurse Practitioner | 66 Bramhall St Fl 1, Portland, ME 04102-3355 | 2019-08-07 |
| 1770145294 | Cynthia Marie Martinez | Nurse Practitioner | 1145 Austin St, Portland, TX 78374-2013 | 2019-07-04 |
| 1528532306 | Matthew James Keelin | Nurse Practitioner | 6801 Ne Cornfoot Rd, Portland, OR 97218-2743 | 2019-01-15 |
| 1659847580 | Colleen Jeanette Scott | Nurse Practitioner | 650 Nw Irving St, Portland, OR 97209-1272 | 2018-10-18 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.