OrganizationActive
Odom Sports Medicine, P.A.
NPI 1275557886 · Sports Medicine (Family Medicine) Physician · Eden Prairie, MN
Provider details
- NPI number
- 1275557886
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Caitlyn Larsen, Billing Supervisor(612) 619-8674
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356
Phone: (952) 224-1919
Fax: (612) 999-1943
Street-level locationGet directions
Mailing address
6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356
Other names (DBA / former)
- Doing business as
- Odom Health & Wellness
- Doing business as
- Odom Health & Wellness
Registry dates
- Enumerated
- 2006-07-27
- Last updated
- 2026-04-29
- Certified
- 2026-04-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.