DIANNA ODOM (PA-C) – Physician Assistant, NPI 1104417021
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
629 PHYSICIAN ASSISTANT in AR
Provider Addresses for DIANNA ODOM (PA-C)
9 MOHAWK CIR
LITTLE ROCK, AR 722072515
Phone: (479) 970-4064
Type: Mailing
2933 LAKEWOOD VILLAGE DR
NORTH LITTLE ROCK, AR 721168033
Phone: (501) 435-1417
Type: Location
1050 MARINA WAY
RUSSELLVILLE, AR 728027914
Phone: (479) 970-4064
Type: Mailing
1808 W Main St
Russellville, AR 728012724
Phone: (479) 968-2841
Type: Location
3140 AR-5
Bryant, AR 72019
Phone: (501) 213-4500
Type: Location
1808 W MAIN ST
RUSSELLVILLE, AR 728012724
Phone: (479) 968-2841
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2021-04-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210413002788 | I | Physician Assistant | AR | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 62 | 59 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 53 | 24 | $0 |
| 99239 | Hospital discharge day management, more than 30 minutes | 14 | 14 | $0 |
Insurance plans in this area (ZIP 72207)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AE | |
| Physician Assistant | AR | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Clinical Social Worker | GA | |
| Infectious Disease, Internal Medicine | AR |
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