Matthew Tyler Odom, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

76768 Issued in TN

Practice address

100 Vermont Ave
Oak Ridge, TN 37830-6471

Phone

(865) 482-1777

Fax

(865) 374-2117

NPI assigned

Mar 23, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

East Tennessee State University Quillen College of Medicine, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1497458095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306471",
            "telephone_number": "865-482-1777",
            "fax_number": "865-374-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306471",
            "telephone_number": "865-482-1777",
            "fax_number": "865-374-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "MATTHEW",
        "middle_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-23",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "76768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q084014",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "odom.matthew.tyler@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 Vermont Ave",
            "city": "Oak Ridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378306471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.