Jared Odom, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

6196 Issued in TN

Practice address

1 Medical Park Blvd
Bristol, TN 37620-7453

Phone

(423) 844-1121

NPI assigned

Mar 23, 2022

Last updated

Jun 14, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Internal Medicine

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ballad Health Hospice Hospice, Bristol, TN, CCN 441558
• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jodom529868@balladhealth.medalliesdirect.net

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.

• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1760405849
  NPD

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

• Mountain States Health Alliance

  dba Ballad Health Hospice

  • Inpatient Hospice
  • Bristol, TN
  • NPI 1033605886
  Care Compare affiliation
• Wellmont Health System

  dba Bristol Regional Medical Center

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation
• Wellmont Health System

  dba Holston Valley Medical Center

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400
  Care Compare affiliation

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749859200000",
    "number": "1710636840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207430",
            "telephone_number": "423-844-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207453",
            "telephone_number": "423-844-1121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1924 Alcoa Hwy # U-114",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379201511",
            "country_code": "US",
            "telephone_number": "865-305-9340",
            "fax_number": "865-305-9144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODOM",
        "first_name": "JARED",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-23",
        "last_updated": "2025-06-14",
        "certification_date": "2025-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "6196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly Ann Nye, MS
• Richard M. O'Connor, MA, ATC, LAT
• Tonia O'Day, RN
• Penny Stanley O'Dell, NP
• Kendra Lauren O'Quinn, DNP, RN, FNP-BC
• Grainne Maria Odonovan Macklin, BA
• Brett C Odum, MD
• Shelby Olds, MD
• Robyn L Olinger, LCSW
• Jenna Oliver, LPC

• Internal Medicine Physician in Bristol, TN
• Providers in Bristol, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2025; 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.