John H. L. Odom Jr. (NPI# 1215953732, PAC ID# 3274502455) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1215953732 |
| PAC ID by PECOS | 3274502455 |
| Professional Enrollment ID | I20040927000127 |
| Full Name | John H. L. Odom Jr. |
| Organization Legal Name | ODOM SPORTS MEDICINE PA |
| Address |
10653 Wayzata Blvd Suite 200 Minnetonka MN 55305-1543 |
| Phone Number | 9522241919 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF COLORADO SCHOOL OF MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | SPORTS MEDICINE |
| Group Practice PAC ID | 0143485607 |
| Number of Group Practice Members | 31 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1313 Penn N Ave, Minneapolis, MN 55411-3047 | 6125432500 | HENNEPIN COUNTY |
| 10653 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1543 | 9522241919 | ODOM SPORTS MEDICINE PA |
| Organization Legal Name | ODOM SPORTS MEDICINE PA |
| Physicians | 38 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dianna Knack | Occupational Therapy | Odom Sports Medicine Pa | 2750 Victoria St N, Roseville, MN 55113-2094 |
| Christa Marie Haskins | Physical Therapy | Odom Sports Medicine Pa | 500 S Cherry St, Waconia, MN 55387-4515 |
| Anastasia K Pitzen | Occupational Therapy | Odom Sports Medicine Pa | 1915 N 34th St, Superior, WI 54880-5575 |
| Charlotte A Meyer | Occupational Therapy | Odom Sports Medicine Pa | 334 Cedardale Dr Se, Owatonna, MN 55060-4467 |
| Allison Marie Holzwarth | Physical Therapy | Odom Sports Medicine Pa | 4685 Park Nicollet Ave Se, Prior Lake, MN 55372-3926 |
| Katherine Price | Occupational Therapy | Odom Sports Medicine Pa | 32 10th Ave S, Hopkins, MN 55343-9402 |
| Jayd A Sharpe | Occupational Therapy | Odom Sports Medicine Pa | 100 Dublin Ct, Mankato, MN 56001-5281 |
| Courtney A Karalus | Physical Therapy | Odom Sports Medicine Pa | 3801 Hart Blvd, Columbia Heights, MN 55421-4106 |
| Jessica A Kimberly | Occupational Therapy | Odom Sports Medicine Pa | 1900 10th St, Silvis, IL 61282-1909 |
| Kelly S Stokes | Physical Therapy | Odom Sports Medicine Pa | 2195 Century Ave S, Woodbury, MN 55125-2943 |
| Street Address |
10653 WAYZATA BLVD SUITE 200 |
| City | MINNETONKA |
| State | MN |
| Zip | 55305-1543 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew J Moran | Physical Therapy | Odom Sports Medicine Pa | 10653 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1543 |
| Katrina A B Kneeskern | Physical Therapy | Odom Sports Medicine Pa | 10653 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1543 |
| Rachel A Hansen | Physical Therapy | Odom Sports Medicine Pa | 10653 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1543 |
| Ann-marie Chesterfield | Physical Therapy | Odom Sports Medicine Pa | 10653 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1543 |
| Trygve J Lundgren | Occupational Therapy | Odom Sports Medicine Pa | 10653 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1543 |
| Amber L Tenerelli | Physical Therapy | Odom Sports Medicine Pa | 10653 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1543 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alecia A Viera | Psychologist, Clinical | 10505 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1502 | |
| Nancy A Foster | Clinical Psychologist | Nancy Foster Phd LLC | 10505 Wayzata Blvd, Minnetonka, MN 55305-1502 |
| Harriet A Kohen | Clinical Social Worker | 10201 Wayzata Blvd, Suite 220, Hopkins, MN 55305-1505 | |
| David S Alter | Psychologist, Clinical | 10505 Wayzata Boulevard, Suite 200, Minnetonka, MN 55305-1506 | |
| Peggy Susan Maki | Psychologist, Clinical | 10520 Wayzata Blvd, Suite 100, Minnetonka, MN 55305-1511 | |
| David R Hardten | Ophthalmology | Minnesota Eye Consultants, Pa | 10709 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1530 |
| Shelby K Anderson | Optometry | Minnesota Eye Consultants, Pa | 10709 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1530 |
| Samuel Frederick Passi | Ophthalmology | Minnesota Eye Consultants, Pa | 10709 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1530 |
| Richard L Lindstrom | Ophthalmology | Minnesota Eye Consultants, Pa | 10709 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1530 |
| Sarah Maki | Ophthalmology | Minnesota Eye Consultants, Pa | 10709 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-1530 |
| Find all physicians in zip 55305 | |||
| City | MINNETONKA |
| Zip Code | 55305 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | MINNETONKA + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.