| Odyssey Family Practice | |
|
11595 Kenai Spur Highway Kenai AK 99611 | |
| (907) 313-4569 | |
| (907) 313-4939 |
| Full Name | Odyssey Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 11595 Kenai Spur Highway, Kenai, Alaska |
| Authorized Official Name and Position | Jared Lee Wallace (OWNER) |
| Authorized Official Contact | 9073134569 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Odyssey Family Practice Po Box 922 Kasilof AK 99610-0922 Ph: () - | Odyssey Family Practice 11595 Kenai Spur Highway Kenai AK 99611 Ph: (907) 313-4569 |
| NPI Number | 1780142042 |
|---|---|
| Provider Enumeration Date | 03/06/2019 |
| Last Update Date | 12/01/2025 |
| Medicare PECOS PAC ID | 3476989062 |
|---|---|
| Medicare Enrollment ID | O20200129002758 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780142042 | NPI | - | NPPES |
| Provider Name | Norvin Perez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1346235819 PECOS PAC ID: 9739120189 Enrollment ID: I20061120000604 |
| Provider Name | Timothy W Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326275082 PECOS PAC ID: 3274787932 Enrollment ID: I20140102001615 |
| Provider Name | Virginia M Avila-haskell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982681151 PECOS PAC ID: 5496769655 Enrollment ID: I20140506000795 |
| Provider Name | Rachel Elizabeth Rekow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659996049 PECOS PAC ID: 6103243712 Enrollment ID: I20200819001486 |
| Provider Name | Heather Nancy Moon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205547205 PECOS PAC ID: 0244601391 Enrollment ID: I20230127000777 |
Central Peninsula General Hospital, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Frontage Rd, Suite 123, Kenai, AK 99611 Phone: 907-283-4611 Fax: 907-283-3992 | |
Medical Network Of Alaska, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10543 Kenai Spur Hwy, Kenai, AK 99611 Phone: 907-357-9590 Fax: 907-357-9593 | |
Ideal Option, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 416 Frontage Rd # 400, Kenai, AK 99611 Phone: 509-222-1275 Fax: 509-491-3031 | |
Independence Healthcare Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Trading Bay Rd Ste 8, Kenai, AK 99611 Phone: 907-283-4633 Fax: 907-262-0832 | |
Kenai Family Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 135 Bidarka St, Suite 101, Kenai, AK 99611 Phone: 907-335-0034 Fax: 907-335-0064 | |
Redoubt Medical Group Llc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 416 Frontage Rd Ste 200, Kenai, AK 99611 Phone: 907-283-6030 Fax: 907-283-3194 | |
Kenai Medical Center Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Frontage Rd, Ste 123, Kenai, AK 99611 Phone: 907-283-4611 Fax: 907-283-3992 |