Organization Active NPI

O'Dell Chiropractic Center LLC

  • Health Service Clinic/Center
  • Richmond, KY
National Provider Identifier
1003202185
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
5284 Issued in KY
Legal business name
O'DELL CHIROPRACTIC CENTER LLC
Practice address
2007 Merchant Dr
Richmond, KY 40475-8167
Phone
(859) 575-1222
Fax
(859) 575-1225
NPI assigned
Apr 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Dr. David M O'Dell, D.C.NPI 1164687398
Title
Owner
Phone
(859) 575-1222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X
Health Service Clinic/Center 261QH0100X 5284 KY Primary

Addresses

Primary practice location

2007 Merchant Dr
Richmond, KY 40475-8167

Mailing address

2007 Merchant Dr
Richmond, KY 40475-8167
Phone (859) 575-1222

Other identifiers 1

IdentifierTypeStateIssuer
7100169940MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150612001626 KY Part B Supplier - Clinic/Group Practice 6901117241 Receives reassigned benefits from 1 practitioner
Practice locations: Richmond, KY

National Provider Directory

National Provider Directory

Locations

2007 Merchant Dr
Richmond, KY 40475
Phone (859) 575-1222

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1003202185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 MERCHANT DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758167",
            "telephone_number": "859-575-1222",
            "fax_number": "859-575-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 MERCHANT DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758167",
            "telephone_number": "859-575-1222",
            "fax_number": "859-575-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O'DELL CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-15",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "O'DELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-575-1222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "KY",
            "license": "5284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100169940",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.