TRACY ODOM (CRNP) – Psychiatry Physician, NPI 1104332527

TRACY ODOM (CRNP) is a healthcare provider. based in Florala, Alabama. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. 1-111973 (AL). The NPI Number for TRACY ODOM (CRNP) is 1104332527

Main info

Female
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
TRACY ODOM (CRNP)
NPI
1104332527
Phone
(334) 684-9208
Address
24245 5TH AVE
Enumeration Date
21 December 2017
Last Update Date
4 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3344930311
Graduation Year
2017 (9 years ago)
PAC ID
7517216617
Group Practice PAC ID
1951643956
Professional Enrollment ID
I20210108001668
Address ID
AL364671727OP101XXAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:8State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

Provider Addresses for TRACY ODOM (CRNP)

  • 24245 5TH AVE

    FLORALA, AL 364423523

    Phone: (334) 684-9208

    Fax: (334) 684-1302

    Type: Location

  • 24245 5th Ave

    Florala, AL 364423523

    Phone: (334) 809-8049

    Type: Location

  • PO BOX 8308

    DOTHAN, AL 363040308

    Phone: (334) 673-8869

    Fax: (334) 673-8851

    Type: Mailing

  • Regency Court, Dothan, Houston County, Alabama, 36305, United States

    DOTHAN, AL 363051179

    Phone: (334) 673-8869

    Fax: (334) 673-8851

    Type: Location

  • PO BOX 342

    FLORALA, AL 364420342

    Phone: (334) 809-8049

    Type: Mailing

  • 101 E PAULK AVE STE A

    OPP, AL 364671727

    Phone: (334) 493-0311

    Fax: (334) 493-0355

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 14 Open Payments records for all available years, with a total value of $304.

Total Amount is formed as General ($304) + Research ($0) + Ownership ($0) = $304.

Last reported payment date: 2024-12-04 • Largest payer in this snapshot: ABBVIE INC. ($142).

Total Amount

$304

General + Research + Ownership

Payments

14

Total payment records

General Amount

$304

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-01-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210108001668INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J1100Injection, dexamethasone sodium phosphate, 1 mg70957$0
99214Established patient office or other outpatient visit, 30-39 minutes321109$0
96372Injection of drug or substance under skin or into muscle29478$0
J0696Injection, ceftriaxone sodium, per 250 mg24040$0
36415Insertion of needle into vein for collection of blood sample14278$0
View full utilization report →

Insurance plans in this area (ZIP 36442)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951643956View full group profile
NameSpecialtyState
Nurse PractitionerAL

Reviews

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Frequently asked questions

Where can patients find TRACY ODOM (CRNP)'s NPI?
You can confirm TRACY ODOM (CRNP) with NPI 1104332527; it appears in the national provider directory.
Is TRACY ODOM (CRNP) active in the national directory?
TRACY ODOM (CRNP)'s public NPI profile is in an active state.
Can you summarize TRACY ODOM (CRNP)'s specialty in plain language?
Clinically, the directory lists TRACY ODOM (CRNP) with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Does TRACY ODOM (CRNP) practice in Alabama?
You will see Florala, Alabama on file for TRACY ODOM (CRNP) alongside any extra practice locations.
Is TRACY ODOM (CRNP) a real provider?
This page reflects official NPPES data for NPI 1104332527. Always confirm identity and privileges with the practice and licensing boards.

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