Nicole Ann Odlum, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11021918A Issued in IN

Practice address

4011 Gateway Blvd
Medical Office Building 3 Suite 3000
Newburgh, IN 47630

Phone

(812) 858-9400

NPI assigned

Jun 21, 2021

Last updated

Sep 26, 2024By the provider in NPPES

Sex

Female

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

Medicare fee-for-service enrollment

Enrolled in IN

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

Pacific NW Un of HS, Col of Osteopathic Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
• The Women's Hospital Hospital, Newburgh, IN, CCN 150149

Merit-based Incentive Payment System (MIPS)

Final score

96.34 of 100Reported as apm

Quality

88.59

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nodlum226283@direct.deaconess.com

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.

• Deaconess Clinic Inc.

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1619123585
  Medicare reassignment Care Compare group NPD
• Deaconess Clinic Inc

  • Pediatrics Physician
  • Washington, IN
  • NPI 1356132310

  Family Medicine

  NPD
• Deaconess Clinic, Inc

  dba Deaconess Clinic I

  • Family Medicine Physician
  • Newburgh, IN
  • NPI 1306092689
  NPD
• Deaconess Clinic, Inc

  dba Deaconess Clinic I

  • Rural Health Clinic/Center
  • Petersburg, IN
  • NPI 1831345792

  Family Medicine

  NPD (past)
• Deaconess Hospital, Inc.

  dba Deaconess Family Medicine Residency

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1629097639
  NPD (past)

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

• Deaconess Hospital Inc

  dba The Women's Hospital

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1780535427
  Care Compare affiliation
• Deaconess Hospital, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1053361642
  Care Compare affiliation
• Deaconess Women's Hospital of Southern Indiana, LLC

  dba The Women's Hospital

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1114023512
  Care Compare affiliation

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1669041067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 GATEWAY BLVD",
            "address_2": "MEDICAL OFFICE BUILDING 3 SUITE 3000",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "47630",
            "telephone_number": "812-858-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 GATEWAY BLVD",
            "address_2": "MEDICAL OFFICE BUILDING 3 SUITE 3000",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "47630",
            "telephone_number": "812-858-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODLUM",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11021918A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "02007176A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Nurrenbern, FNP
• Nurturing Mama, LLC
• Ashlee Faith O'Bryan, RBT
• Misty Obrian
• Desiree Oden
• David G Ogle, DDS
• Ohio Valley Mindhealth LLC
• Ohio Valley Pain Intervention LLC (Genesis Health and Wellness)
• Ohio Valley Speech & Language Center LLC
• Old Town Counseling of Newburgh LLC

• Family Medicine Physician in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.