Odam Medical Group

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ODAM MEDICAL GROUP

Practice address

700 Penn St
Foley, MN 56329-8700

Phone

(320) 774-3800

Fax

(320) 774-3360

NPI assigned

Jul 8, 2025

Organization subpart

No

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

Authorized official

Name

Robert Larbi-Odam, MDNPI 1457311409

Title

Ceo

Phone

(612) 871-2312

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Odam Medical Group

  • Clinic/Center
  • Crystal, MN
  • NPI 1578934683

  O20160321002318

  Same enrollment
• Odam Medical Group

  • Primary Care Clinic/Center
  • Saint Cloud, MN
  • NPI 1902392525

  O20160321002318

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Odam Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Odam Medical Group

  • Primary Care Clinic/Center
  • Moorhead, MN
  • NPI 1366241309
  NPD tax ID
• Odam Medical Group

  • Primary Care Clinic/Center
  • Saint Cloud, MN
  • NPI 1902392525
  NPD tax ID

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Larbi-Odam, MD

  • Family Medicine Physician
  • Crystal, MN
  • NPI 1457311409
  NPD Authorized official
• Selase Adzo Agudu-Morgan, FNP-C

  • Family Nurse Practitioner
  • Farmington, MN
  • NPI 1891278693
  NPD
• Samuel Yaw Boadu, DNP

  • Nurse Practitioner
  • Saint Paul, MN
  • NPI 1063517100
  NPD
• Muna Saeed Farah

  • Family Nurse Practitioner
  • Saint Paul, MN
  • NPI 1780247015
  NPD
• Salma Mohamud

  • Family Nurse Practitioner
  • Saint Cloud, MN
  • NPI 1891686507
  NPD
• Comfort Lumyedang Nchanji, MD

  • Family Medicine Physician
  • Crystal, MN
  • NPI 1609493147
  NPD
• Kristofer Michael Wallman, MPAS, PA-C

  • Medical Physician Assistant
  • Foley, MN
  • NPI 1962439547
  NPD

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1538059779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 PENN ST",
            "city": "FOLEY",
            "state": "MN",
            "postal_code": "563298700",
            "telephone_number": "320-774-3800",
            "fax_number": "612-871-2163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PENN ST",
            "city": "FOLEY",
            "state": "MN",
            "postal_code": "563298700",
            "telephone_number": "320-774-3800",
            "fax_number": "320-774-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODAM MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "LARBI-ODAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-871-2312",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Todd Paul Nelson, RPH
• Kristine Lynn Noack
• Steven William O'Brien, D.D.S.
• Sharon Peterson-Schmit
• Ellen Jill Petron, C.M.T.
• Casey Marie Schmidt, LPN
• Tara Ashley Schmidt, MASSAGE THERAPIST
• Schu-Tran LLC

• All providers in Foley, MN
• Primary Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.