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JOHN ODOM MD
NPI 1215953732
Physical Medicine & Rehabilitation - Sports Medicine in Eden Prairie, MN

Active since July 15, 2006PECOS EnrolledAccepts Medicare Assignment
6545 FLYING CLOUD DR STE 201, EDEN PRAIRIE, MN 55344(952) 224-1919(612) 999-1943 Get Directions Write a Review

NPPES record last updated: April 29, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 29, 2026, Jun 25, 2024, Jun 13, 2024 (3 updates tracked since 2024).

About John Odom Md NPPES

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

JOHN ODOM MD (NPI 1215953732) is an individual sports medicine provider in Eden Prairie, Minnesota, licensed in Minnesota (44235) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Colorado School Of Medicine, Denver (1999).

NPPES Registry Identity

NPI1215953732
Entity TypeIndividualMale
Primary Taxonomy2081S0010X
Provider Legal NameJOHN ODOMCredential: MD
Location Address6545 FLYING CLOUD DR STE 201Eden Prairie, MN 55344-3356
Mailing Address6545 Flying Cloud Dr Ste 201Eden Prairie, MN 55344-3356 · (952) 224-1919 · Fax (612) 999-1943
Phone(952) 224-1919
Fax(612) 999-1943
Sole ProprietorNo
Medical School CMSUniversity Of Colorado School Of Medicine, DenverGraduated 1999
Enumeration DateJuly 15, 2006
Last NPPES UpdateApril 29, 20263 updates tracked since enumeration
NPPES CertifiedApril 29, 2026
✔ NPI 1215953732 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081S0010X
License✔ Licensed in MN · 44235
Definition
A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 44235 (MN)
6545 FLYING CLOUD DR STE 201, Eden Prairie, MN 55344
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

John Odom Md 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 ID3274502455
PECOS Enrollment IDI20040927000127
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

6

Medicare enrollment records show John Odom reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Odom Sports Medicine, P.A.
Same address
Sports Medicine
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
  • Reassigned Medicare billing, Minnesota enrollment
  • Medicare enrollment name: Odom Sports Medicine PA
  • 92 clinicians in this Medicare group
NPI 1275557886 (952) 224-1919
Hennepin County
7.7 mi
Federally Qualified Health Center (FQHC)
3111 FIRST AVE. SO.
Minneapolis, MN 55408
  • Reassigned Medicare billing, Minnesota enrollment
  • 192 clinicians in this Medicare group
NPI 1841761954 (612) 348-5553
Carris Health - Redwood LLC
86 mi
Emergency Medicine
101 CARING WAY
Redwood Falls, MN 56283
  • Reassigned Medicare billing, Minnesota enrollment
  • 183 clinicians in this Medicare group
NPI 1265914048 (507) 637-4500
Sanford Health Network
100 mi
Rural Health
308 8TH ST N
Mountain Lake, MN 56159
  • Reassigned Medicare billing, Minnesota enrollment
  • Also billed through NPI 1780781054 (Minnesota)
  • 279 clinicians in this Medicare group
NPI 1568469039 (507) 427-3332
Ccm Health
113 mi
Critical Access
824 N 11TH ST
Montevideo, MN 56265
  • Reassigned Medicare billing, Minnesota enrollment
  • 114 clinicians in this Medicare group
NPI 1720086028 (320) 269-8877
St. Francis Medical Center
182 mi
Critical Access
2400 ST FRANCIS DR
Breckenridge, MN 56520
  • Reassigned Medicare billing, Minnesota enrollment
  • 52 clinicians in this Medicare group
NPI 1891954574 (218) 643-3000

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

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
39 services16 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
14 services14 patients

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Extra heavy duty wheelchair K0007
DME-Wheelchairs · category DD000N
1 supplier11 claims11 services$61.93 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

LINDA JEANNE MIX YATES SLP
Speech-Language Pathologist
6545 FLYING CLOUD DR STE 201
EDEN PRAIRIE, MN 55344
Hennepin County (612) 364-1901
RILEY BREN
Physical Therapist
6545 FLYING CLOUD DR STE 201
EDEN PRAIRIE, MN 55344
Hennepin County (612) 364-1901
KAITLIN VAITH
Physical Therapist
6545 FLYING CLOUD DR STE 201
EDEN PRAIRIE, MN 55344
Hennepin County (612) 364-1901
AMY CANTELE
Speech-Language Pathologist
6545 FLYING CLOUD DR STE 201
EDEN PRAIRIE, MN 55344
Hennepin County (612) 364-1901
FAITH MADER
Speech-Language Pathologist
6545 FLYING CLOUD DR STE 201
EDEN PRAIRIE, MN 55344
Hennepin County (612) 364-1901
MADELINE CHARBONNEAU
Occupational Therapist
6545 FLYING CLOUD DR STE 201
EDEN PRAIRIE, MN 55344
Hennepin County (952) 224-1919
RACHEL ANN BABER OTR/L
Occupational Therapist
6545 FLYING CLOUD DR STE 201
EDEN PRAIRIE, MN 55344
Hennepin County (612) 364-1901
SAMANTHA PARMETER
Occupational Therapist
6545 FLYING CLOUD DR STE 201
EDEN PRAIRIE, MN 55344
Hennepin County (612) 364-1901

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 John Odom's NPI number?

The NPI number for John Odom is 1215953732. It was assigned to this individual provider in the NPPES registry on July 15, 2006.

Where is John Odom located?

John Odom practices at 6545 Flying Cloud Dr Ste 201, Eden Prairie, MN 55344. The listed phone number is (952) 224-1919.

What is John Odom's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Sports Medicine, with taxonomy code 2081S0010X.

Is John Odom enrolled in Medicare?

Yes. John Odom is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for John Odom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Odom reassigns Medicare benefits to 6 organizations: Odom Sports Medicine, P.A. (Eden Prairie, MN), Hennepin County (Minneapolis, MN), Carris Health - Redwood LLC (Redwood Falls, MN), Sanford Health Network (Mountain Lake, MN), Ccm Health (Montevideo, MN) and 1 more organization, listed in the Medicare section above. 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 John Odom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for John Odom was last updated on April 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.