Odom Sports Medicine, P.A.
NPI 1275557886 · Sports Medicine (Family Medicine) Physician · Eden Prairie, MN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Odom Sports Medicine, P.A. is a Sports Medicine (Family Medicine) Physician organization in Eden Prairie, MN (NPI 1275557886).
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
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
Mailing address
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
Frequently asked questions
- What is Odom Sports Medicine, P.A.'s NPI number?
- Odom Sports Medicine, P.A.'s National Provider Identifier (NPI) is 1275557886, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Odom Sports Medicine, P.A.?
- Odom Sports Medicine, P.A. is classified in the NPPES registry as Sports Medicine (Family Medicine) Physician (Allopathic & Osteopathic Physicians).
- Where is Odom Sports Medicine, P.A. located?
- Odom Sports Medicine, P.A.'s practice location on file with NPPES is 6545 Flying Cloud Dr Ste 201, Eden Prairie, MN 55344-3356.
- What is Odom Sports Medicine, P.A.'s phone number?
- The practice phone number listed in the NPPES registry for Odom Sports Medicine, P.A. is (952) 224-1919.
- Does Odom Sports Medicine, P.A. accept Medicare?
- Odom Sports Medicine, P.A. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Odom Sports Medicine, P.A.?
- The authorized official listed on Odom Sports Medicine, P.A.'s NPPES record is Caitlyn Larsen, Billing Supervisor. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Odom Sports Medicine, P.A.'s NPI active?
- Yes — Odom Sports Medicine, P.A.'s NPI (1275557886) is active in the NPPES registry as of the last update on 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.