Individual provider Active NPI

Dylan Zhang Odell

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1033087184
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4047655 Issued in KY
Practice address
2141 Sycamore Ave
Louisville, KY 40206-2013
Phone
(502) 895-5417
NPI assigned
Oct 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4047655 KY Primary

Addresses

Primary practice location

2141 Sycamore Ave
Louisville, KY 40206-2013

Mailing address

305 Lyndon LN
Louisville, KY 40222-4603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260618002886 KY Practitioner - Nurse Practitioner 2567934763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical Kentucky, LLCGroup PAC ID 3173952637, 28 clinicians
Kentucky Post-Acute Medical Services 1 PSCGroup PAC ID 9234471426, 25 clinicians

Practice addresses (Care Compare)

3500 Good Samaritan Way
Louisville, KY 40299-6117
Phone (502) 267-7403

723 Old Burkesville Rd
Albany, KY 42602-1654
Phone (606) 387-8000

901 Blankenbaker Pkwy
Louisville, KY 40243-1884
Phone (502) 289-5593

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4047655KYMDPsychiatric/Mental Health Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1033087184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 LYNDON LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 SYCAMORE AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402062013",
            "telephone_number": "502-895-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELL",
        "first_name": "DYLAN",
        "middle_name": "ZHANG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-29",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4047655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.