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ODOM SPORTS MEDICINE, P.A.
NPI 1275557886
Family Medicine - Sports Medicine in Eden Prairie, MN

Active since July 27, 2006
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 25, 2026.

Record update history: Apr 29, 2026, Apr 23, 2024, Jul 13, 2020 and 1 more (4 updates tracked since 2020).

About Odom Sports Medicine, P.a. NPPES

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

ODOM SPORTS MEDICINE, P.A. (NPI 1275557886), doing business as Odom Health & Wellness, is a healthcare organization registered as a sports medicine in Eden Prairie, Minnesota and active in the NPI registry since July 2006. The organization lists Caitlyn Larsen, Billing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1275557886
Entity TypeOrganization
Primary Taxonomy207QS0010X
Legal Business NameODOM SPORTS MEDICINE, P.A.
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
Organization SubpartNo
Authorized OfficialCaitlyn LarsenBilling Supervisor · (612) 619-8674
Enumeration DateJuly 27, 2006
Last NPPES UpdateApril 29, 20264 updates tracked since enumeration
NPPES CertifiedApril 29, 2026
✔ NPI 1275557886 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
6545 FLYING CLOUD DR STE 201, Eden Prairie, MN 55344
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Other Names 1

Doing Business AsOdom Health & Wellness

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Odom Sports Medicine, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

94

Medicare enrollment records show 94 clinicians reassign Medicare billing to Odom Sports Medicine, P.A., which bills Medicare for the services they deliver. Of these, 36 practice at this address and 55 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 4

Physical Therapist in Private Practice49
Occupational Therapist in Private Practice31
Qualified Speech Language Pathologist13
Family Practice1

Nearest to this location (20)

See all 94
Gretta Adams, PT, DPT
Physical Therapist in Private Practice
NPI 1841944543
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ Accepts MedicareSame address
Daniel Bielski
Physical Therapist in Private Practice
NPI 1598654139
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ Accepts MedicareSame address
Allison Brandts
Occupational Therapist in Private Practice
NPI 1649731662
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ Accepts MedicareSame address
Tabitha Butler
Physical Therapist in Private Practice
NPI 1487422648
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(612) 364-1901
✔ Accepts MedicareSame address
Madeline Charbonneau
Occupational Therapist in Private Practice
NPI 1114849759
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ Accepts MedicareSame address
Maya Delport, OTR/L
Occupational Therapist in Private Practice
NPI 1275183154
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ Accepts MedicareSame address
Zachary Engel
Occupational Therapist in Private Practice
NPI 1891617338
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ Accepts MedicareSame address
Julia Erickson
Occupational Therapist in Private Practice
NPI 1548115744
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ Accepts MedicareSame address
Jayden Latterell
Qualified Speech Language Pathologist
NPI 1386476919
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(612) 364-1901
✔ Accepts MedicareSame address
Katie Meyers
Physical Therapist in Private Practice
NPI 1679825558
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ Accepts MedicareSame address
Andrew Moran, DPT
Physical Therapist in Private Practice
NPI 1487145405
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ Accepts MedicareSame address
John Odom, MD
Family Practice
NPI 1215953732
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ PECOS✔ Accepts MedicareSame address
Kjerstin Ohnstad
Physical Therapist in Private Practice
NPI 1548489487
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ Accepts MedicareSame address
Emily Parnell, PT
Physical Therapist in Private Practice
NPI 1700419207
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(952) 224-1919
✔ Accepts MedicareSame address
Hannah Schliemann
Qualified Speech Language Pathologist
NPI 1184518177
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(612) 364-1901
✔ Accepts MedicareSame address
Jenna Bartunek
Occupational Therapist in Private Practice
NPI 1669230637
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(612) 364-1901
Same address
Amy Cantele
Qualified Speech Language Pathologist
NPI 1093283772
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(612) 364-1901
Same address
Cassidy Krawczak-Kummrow
Qualified Speech Language Pathologist
NPI 1699668533
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(612) 364-1901
✔ Accepts MedicareSame address
Jacqueline Pieper
Qualified Speech Language Pathologist
NPI 1679315774
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(612) 364-1901
✔ Accepts MedicareSame address
Claire Rondeau
Qualified Speech Language Pathologist
NPI 1225811250
6545 FLYING CLOUD DR STE 201
Eden Prairie, MN 55344
(612) 364-1901
✔ Accepts MedicareSame address
See all 94 clinicians

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

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 Odom Sports Medicine, P.A.'s NPI number?

The NPI number for Odom Sports Medicine, P.A. is 1275557886. It was assigned to this organization in the NPPES registry on July 27, 2006. The provider is doing business as Odom Health & Wellness.

Where is Odom Sports Medicine, P.A. located?

Odom Sports Medicine, P.A. is located at 6545 Flying Cloud Dr Ste 201, Eden Prairie, MN 55344. The listed phone number is (952) 224-1919.

What is Odom Sports Medicine, P.A.'s specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Odom Sports Medicine, P.A. enrolled in Medicare?

Yes. Odom Sports Medicine, P.A. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Odom Sports Medicine, P.A.?

According to the CMS Revalidation Reassignment List (October 2026 release), 94 clinicians in 4 Medicare specialties reassign their Medicare billing to Odom Sports Medicine, P.A.. A 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 the clinician's services. The largest specialties are Physical Therapist in Private Practice (49), Occupational Therapist in Private Practice (31) and Qualified Speech Language Pathologist (13). Of these, 36 practice at this address and 55 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Odom Sports Medicine, P.A. 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 6 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.