Mrs Lisa Nicole Odom, - Medicare Pediatrics in Coeur D Alene, ID

Mrs Lisa Nicole Odom, is a medicare enrolled "Pediatrics" physician in Coeur D Alene, Idaho. Her current practice location is 1090 W Park Pl, Coeur D Alene, Idaho. You can reach out to her office (for appointments etc.) via phone at (208) 215-2005.

Mrs Lisa Nicole Odom is licensed to practice in Idaho (license number M-13382) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1598007668.

Contact Information

Mrs Lisa Nicole Odom,
1090 W Park Pl,
Coeur D Alene, ID 83814-2785
(208) 215-2005
(844) 807-3782



Physician's Profile

Full NameMrs Lisa Nicole Odom
GenderFemale
SpecialityPediatrics
Location1090 W Park Pl, Coeur D Alene, Idaho
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1598007668
  • Provider Enumeration Date: 03/26/2013
  • Last Update Date: 08/25/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 5890082804
  • Enrollment ID: I20160919002487

Medical Identifiers

Medical identifiers for Mrs Lisa Nicole Odom such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1598007668NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics M-13382 (Idaho)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Lisa Nicole Odom allows following entities to bill medicare on her behalf.
Entity NameKootenai Health, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235288655
PECOS PAC ID: 4789641598
Enrollment ID: O20041214000230

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Entity NameDirne Health Centers, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285686477
PECOS PAC ID: 2466353354
Enrollment ID: O20050303001041

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Entity NameKootenai Health Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174661151
PECOS PAC ID: 1355792276
Enrollment ID: O20240111003252

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Lisa Nicole Odom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Lisa Nicole Odom,
Po Box 1387,
Hayden, ID 83835-1387

Ph: (208) 415-0299
Mrs Lisa Nicole Odom,
1090 W Park Pl,
Coeur D Alene, ID 83814-2785

Ph: (208) 215-2005

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Pediatrics Doctors in Coeur D Alene, ID

Dr. Thomas R Rau, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814
Phone: 208-667-0585    Fax: 208-667-0876
Terence Earl Neff, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814
Phone: 208-667-0585    Fax: 208-667-0876
Dr. Brook Yuknis Lang, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814
Phone: 208-625-5185    Fax: 208-625-5892
Dr. Mary Jo Shaw, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814
Phone: 208-667-0585    Fax: 208-667-0876
Dr. Beth Ann Martin, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814
Phone: 208-625-6446    Fax: 208-625-5931
Dr. Cheri Kathleen Savage,
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814
Phone: 208-667-0585    Fax: 208-667-0876
Dr. Rene Chalom, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814
Phone: 208-625-5930    Fax: 208-625-5931

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