KATIE ODOM (NP) – Nurse Practitioner, NPI 1194462010
Nurse Practitioner
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for KATIE ODOM (NP)
255 Boderman
Bloomsdale, MO 636279099
Phone: (573) 483-9492
Type: Location
255 BODERMAN
BLOOMSDALE, MO 636279099
Phone: (573) 483-9492
Type: Mailing
PO BOX 957683
SAINT LOUIS, MO 631959099
Phone: (573) 756-6751
Fax: (573) 760-8044
Type: Mailing
1106 HAZEL LN
FARMINGTON, MO 636401999
Phone: (573) 756-6751
Fax: (573) 760-8044
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: 2022-07-29
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 |
|---|---|---|---|---|
| I20220729002687 | I | Nurse Practitioner | MO | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63627)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| Internal Medicine | TX | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Physician Assistant | MO |
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