1. Home
  2. Directory
  3. Oklahoma
  4. Tulsa
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

ERIK ODOM DO
NPI 1023770039
Student in an Organized Health Care Education/Training Program in Tulsa, OK

Active since October 06, 2021PECOS Enrolled
1111 W 17TH ST, TULSA, OK 74107(918) 582-1972 Get Directions Write a Review

NPPES record last updated: August 8, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 8, 2024, May 4, 2023, Oct 6, 2021 (3 updates tracked since 2021).

About Erik Odom Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ERIK ODOM DO (NPI 1023770039) is an individual student in an organized health care education/training program in Tulsa, Oklahoma and active in the NPI registry since October 2021. He is enrolled in Medicare PECOS and maintains a secondary practice location in Wagoner.

NPPES Registry Identity

NPI1023770039
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameERIK ODOMCredential: DO
Location Address1111 W 17TH STTulsa, OK 74107-1886
Mailing Address1111 W 17th StTulsa, OK 74107-1886
Phone(918) 582-1972
Sole ProprietorYes
Enumeration DateOctober 6, 2021
Last NPPES UpdateAugust 8, 20243 updates tracked since enumeration
NPPES CertifiedAugust 8, 2024
✔ NPI 1023770039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 8582 (OK)
1111 W 17TH ST, Tulsa, OK 74107
Open in Google Maps ↗

Secondary Practice Location 1

Location 11200 W Cherokee StWagoner, OK 74467-4624 · Phone (918) 485-5514 · Fax (918) 485-1383

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Erik Odom Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Erik Odom reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

State Of Oklahoma
3.8 mi
Psychiatric Hospital
2323 S HARVARD AVE
Tulsa, OK 74114
  • Reassigned Medicare billing, Oklahoma enrollment
  • 170 clinicians in this Medicare group
NPI 1578580916 (918) 293-2140
Wagoner Hospital Authority
36 mi
General Acute Care Hospital
1200 W CHEROKEE ST
Wagoner, OK 74467
  • Reassigned Medicare billing, Oklahoma enrollment
  • 30 clinicians in this Medicare group
NPI 1386611580 (918) 485-5514

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRAHAM NATHAN JAMEISON MAT, ATC
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 237-2828
MARIYA BOBEN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
KARLYN TANZEY
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
KAYLEY ANTHAMATTEN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
CHASE YAGER
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (405) 613-1540
MACKENZIE LYNN HATTABAUGH
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
ASHLEE EASTMAN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 805-1752
DAVID ROBERT WAXMAN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Erik Odom's NPI number?

The NPI number for Erik Odom is 1023770039. It was assigned to this individual provider in the NPPES registry on October 6, 2021.

Where is Erik Odom located?

Erik Odom practices at 1111 W 17th St, Tulsa, OK 74107. The listed phone number is (918) 582-1972.

What is Erik Odom's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Erik Odom enrolled in Medicare?

Yes. Erik Odom is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Erik Odom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Erik Odom reassigns Medicare benefits to 2 organizations: State Of Oklahoma (Tulsa, OK) and Wagoner Hospital Authority (Wagoner, OK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Erik Odom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Erik Odom accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Erik Odom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Erik Odom was last updated on August 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.