Family Medicine
ODYSSEY FAMILY PRACTICE
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1780142042 · enumerated 2019-03-06 · record updated 2025-12-01. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: JARED WALLACE PA-C, Owner · (907) 313-4569
Addresses and phones
- Practice location 11595 KENAI SPUR HIGHWAY, KENAI, AK, 99611 (907) 313-4569 Fax (907) 313-4939 Google Maps Apple Maps OpenStreetMap
- Mailing address PO BOX 922, KASILOF, AK, 99610-0922 Google Maps Apple Maps OpenStreetMap
Specialties
- Clinic/Center, Occupational Medicine 261QX0100X
- Clinical Medical Laboratory 291U00000X
- Family Medicine 207Q00000X · Primary
In this directory
Locations and evidence
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Practice location
KENAI, AK, 99611
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.