NPIMap

Individual provider Active NPI

Matthew Richard Odom, M.D.

  • Emergency Medicine Physician
  • Gainesville, FL
National Provider Identifier
1780828988
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME112150 Issued in FL
Practice address
1050 NW 8TH Ave Ste 20
Gainesville, FL 32601-4998
Phone
(352) 379-7900
Fax
(352) 379-2971
NPI assigned
May 1, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TRN13500 FL
Family Medicine Physician 207Q00000X ME112150 FL
Emergency Medicine Physician 207P00000X ME112150 FL Primary

Addresses

Primary practice location

1050 NW 8TH Ave Ste 20
Gainesville, FL 32601-4998

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other practice location 1

922 E Call St
Starke, FL 32091-3616
Phone (904) 368-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120522000996 FL Practitioner - Emergency MedicinePractitioner - Family Practice 2769645126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Miami, LM Miller School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gainesville After Hours ClinicGroup PAC ID 7315966850, 4 clinicians

Practice addresses (Care Compare)

1050 NW 8TH Ave
Suite 10
Gainesville, FL 32601-4998
Phone (352) 379-7900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME112150FLMDEmergency Medicine Physician
TRN13500FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gainesville After Hours Clinic Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1050 NW 8th Ave
Ste 10
Gainesville, FL 32601
Phone (352) 271-3200

9111 SW 53rd Pl
Ste C
Gainesville, FL 32608

1050 NW 8th Ave
Ste 20
Gainesville, FL 32601
Phone (352) 377-5007

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

922 E Call St
Starke, FL 32091
Phone (904) 368-2300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1780828988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 NW 8TH AVE STE 20",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326014998",
            "telephone_number": "352-379-7900",
            "fax_number": "352-379-2971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "922 E Call St",
            "address_purpose": "LOCATION",
            "city": "Starke",
            "state": "FL",
            "postal_code": "320913616",
            "country_code": "US",
            "telephone_number": "904-368-2300",
            "fax_number": "904-368-2306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODOM",
        "first_name": "MATTHEW",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-01",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN13500",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME112150",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME112150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.