NPIMap

Individual provider Active NPI

Tara L Odle, MD

  • Emergency Medicine Physician
  • Louisville, KY
National Provider Identifier
1184726085
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35847 Issued in KY
Practice address
4000 Kresge Way
Emergency Department Baptist Health Louisville
Louisville, KY 40207-4605
Phone
(502) 899-7646
Fax
(502) 899-7648
NPI assigned
Sep 1, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35847 KY Primary

Addresses

Primary practice location

4000 Kresge Way
Emergency Department Baptist Health Louisville
Louisville, KY 40207-4605

Mailing address

PO Box 6749
Louisville, KY 40206-0749
Phone (502) 899-7646

Other identifiers 5

IdentifierTypeStateIssuer
200355490MedicaidIN
50042929OtherKYPASSPORT
35847OtherKYKY LICENSE
64042492MedicaidKY
000000786307OtherKYANTHEM BC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091130000481 KY Practitioner - Emergency Medicine 8921147265 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisville Emergency Medicine Associates PSCGroup PAC ID 1557357613, 11 clinicians
Louisville Observational Medicine Associates PSCGroup PAC ID 2860890704, 32 clinicians

Practice addresses (Care Compare)

4000 Kresge Way
Louisville, KY 40207-4605
Phone (502) 899-7646

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.66 of 100Reported as group
Quality
75.39
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Louisville Observational Medicine Associates PSC Emergency Medicine CurrentSince Sep 7, 2021 Accepting new patients
Louisville Emergency Medicine Associates PSC Emergency Medicine CurrentSince Aug 1, 2013 Accepting new patients
Southern Emergency Medical Specialists, P.S.C. Emergency Medicine Past Accepting new patients
Louisville Radiology Imaging Consultants, PLLC Past Accepting new patients
Kentuckiana Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients
Kentuckiana Emergency Physicians Past Accepting new patients

Locations

4000 Kresge Way
St Matthews, KY 40207
Phone (502) 459-7902

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1184726085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6749",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402060749",
            "telephone_number": "502-899-7646",
            "fax_number": "502-899-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 KRESGE WAY",
            "address_2": "EMERGENCY DEPARTMENT BAPTIST HEALTH LOUISVILLE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074605",
            "telephone_number": "502-899-7646",
            "fax_number": "502-899-7648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODLE",
        "first_name": "TARA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "35847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200355490",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50042929",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY LICENSE",
            "identifier": "35847",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64042492",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000786307",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.