ODOM SPORTS MEDICINE P.A. NPI 1740625870

NPI Information

  • NPI: 1740625870
  • Provider Name: ODOM SPORTS MEDICINE, P.A.
  • Classification: Family Medicine - 207QS0010X
  • Specialization: Sports Medicine
  • Entity Type: Organization
  • Doing Business As: ODOM HEALTH AND WELLNESS
  • Address: 500 S CHERRY ST
    WACONIA, MN
    ZIP 55387
  • Phone: (952) 856-4722

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NPI Details

ODOM SPORTS MEDICINE, P.A. is a sports medicine family medicine in Waconia, MN. The provider is 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. ODOM SPORTS MEDICINE, P.A. NPI is 1740625870. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Odom Health And Wellness.

The provider's business location address is:

500 S CHERRY ST
WACONIA, MN
ZIP 55387-515
Phone: (952) 856-4722

The provider's authorized official is John H.l. Odom .
The authorized official title is President and has the following contact phone number (952) 224-1919.

The enumeration date for this NPI number is 5/2/2013 and was last updated on 5/2/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225100000XPhysical TherapistNo
2225X00000XOccupational TherapistNo
3207QS0010XFamily MedicineSports MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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