Odam Medical Group

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ODAM MEDICAL GROUP

Practice address

1521 Northway Dr Ste 116
Saint Cloud, MN 56303-1274

Phone

(320) 774-3800

Fax

(320) 774-3360

NPI assigned

Jul 6, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Robert Larbi-OdamNPI 1457311409

Title

Ceo

Phone

(612) 871-2312

Specialties & licenses 2

Addresses

Other names 1

• ODAM MEDICAL GROUP - ST. CLOUD Other name

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

  • Primary Care Clinic/Center
  • Foley, MN
  • NPI 1538059779

  O20160321002318

  Same enrollment
• Odam Medical Group

  • Clinic/Center
  • Crystal, MN
  • NPI 1578934683

  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
  • Foley, MN
  • NPI 1538059779
  NPD tax ID

Locations

Practitioners 3

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
• Samuel Yaw Boadu, DNP

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

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

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1902392525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 NORTHWAY DR STE 116",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031274",
            "telephone_number": "320-774-3800",
            "fax_number": "320-774-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 NORTHWAY DR STE 116",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031274",
            "telephone_number": "320-774-3800",
            "fax_number": "320-774-3360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Main St W Ste B",
            "address_purpose": "LOCATION",
            "city": "Rice",
            "state": "MN",
            "postal_code": "563679516",
            "country_code": "US",
            "telephone_number": "320-774-3800",
            "fax_number": "320-774-3360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ODAM MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-06",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "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_name_prefix": "Dr."
    },
    "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": [
        {
            "organization_name": "ODAM MEDICAL GROUP - ST. CLOUD",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ODAM MEDICAL GROUP - ST. CLOUD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Justice Obimpeh
• Heather Joy Oborn, MSW, LICSW
• Faith Obot
• Jesse Robert Obright, PHARMD
• Occupational Medicine Clinic
• Kimberley Diana Odegaard
• Christopher Odens
• Patrick Wayne Odens, MD
• Adewale O Odofin, M.D
• Cham Ochala Odol

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.