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

Q: 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.

Q: 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.

Q: When was this NPI record last updated?

The NPPES record for Erik Odom was last updated on August 8, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 06, 2021PECOS EnrolledAccepts Medicare Assignment

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: July 26, 2026.

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

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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, maintains a secondary practice location in Wagoner, and is a graduate of Oklahoma State University College Of Osteopathic Medicine (2023).

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

Medical School CMSOklahoma State University College Of Osteopathic MedicineGraduated 2023

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

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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 Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Erik Odom Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961941570

PECOS Enrollment IDI20240827004367

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.

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