Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Odom Sports Medicine, PA

Organization Sports Medicine (Family Medicine) Physician · NPI 1740625870

Odom Sports Medicine, PA is a Sports Medicine (Family Medicine) Physician in Waconia, Minnesota. Registered with an NPI since 2013.

In the registry since
2013
Specialties on file
3
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

500 S Cherry St
Waconia, MN 55387-4515
Phone: (952) 856-4722
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X
Physical Therapist Taxonomy 225100000X
Occupational Therapist Taxonomy 225X00000X

Record details

NPI number1740625870
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationOdom Sports Medicine, PA
Authorized official John Odom — President · (952) 224-1919
Other names Odom Health And Wellness
NPI enumeratedMay 2, 2013
Last updated in NPPESMay 2, 2013
Mailing address10500 Wayzata Blvd, Minnetonka, MN 55305-1511