NPIMap

Individual provider Active NPI

Melissa K Odle, FNP

  • Nurse Practitioner
  • Sesser, IL
National Provider Identifier
1225308406
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.017951 Issued in IL
Practice address
6294 State Highway 154
Sesser, IL 62884-2163
Phone
(618) 625-6979
Fax
(618) 625-6979
NPI assigned
Jan 5, 2012
Last updated
Dec 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.017951 IL Primary
Family Nurse Practitioner 363LF0000X 209017951 IL
Registered Nurse 163W00000X 041344692 IL

Addresses

Primary practice location

6294 State Highway 154
Sesser, IL 62884-2163

Mailing address

PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20190222001403 IL Practitioner - Nurse Practitioner 1850630617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Mobile MD Illinois LLCGroup PAC ID 0941701239, 5 clinicians

Practice addresses (Care Compare)

Harwood Heights, IL 60706
Phone (317) 559-0950

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.16 of 100Reported as group
Quality
70.69
Promoting interoperability
99
Improvement activities
40
Cost
71.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041344692ILMDRegistered Nurse
209.017951ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Clinic, Inc Nurse Practitioner CurrentSince Jan 14, 2023 Accepting new patients
My Mobile MD Illinois LLC CurrentSince Sep 22, 2025 Accepting new patients
Deaconess Illinois Clinic, Inc Nurse Practitioner CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Clinic, Inc Nurse Practitioner Current Accepting new patients

Locations

205 Bailey Ln
Benton, IL 62812
Phone (618) 435-8189

205 Bailey Ln
Ste F
Benton, IL 62812
Phone (618) 882-4200

1000 Eleven S
Columbia, IL 62236
Phone (618) 663-3323

7444 W Wilson Ave
Ste 105
Harwood Heights, IL 60706
Phone (847) 480-8851

429 E Vermont St
Ste 110
Indianapolis, IN 46202
Phone (765) 749-9871

Interoperability endpoints

  • Direct secure messaging: melissa.odle.1@27782.direct.athenahealth.com

Organizations & group practices 4

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 7

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": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1225308406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "628220155",
            "telephone_number": "618-724-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6294 STATE HIGHWAY 154",
            "city": "SESSER",
            "state": "IL",
            "postal_code": "628842163",
            "telephone_number": "618-625-6979",
            "fax_number": "618-625-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODLE",
        "first_name": "MELISSA",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.017951",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209017951",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041344692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sesser, IL

Sources for this page

Verify at the official NPI Registry.