Active NPI
David R Odiorne, DC
- Chiropractor
- Portland, OR
National Provider Identifier
1063455731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CR580
- Practice address
- 14689 NW Werner LN
Portland, OR 97229 - Phone
- (503) 645-7520
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38007840 | IL | |
| Chiropractor | 111N00000X | CR580 | ME | Primary |
Addresses
Primary practice location
14689 NW Werner LN
Portland, OR 97229
Mailing address
2284 Lower Lake Road
Seneca Falls, NY 13148
Phone (315) 712-4149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38007840 | IL | MD | Chiropractor |
| CR580 | ME | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323302400000",
"number": "1063455731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2284 LOWER LAKE ROAD",
"city": "SENECA FALLS",
"state": "NY",
"postal_code": "13148",
"telephone_number": "315-712-4149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14689 NW WERNER LN",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97229",
"telephone_number": "503-645-7520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODIORNE",
"first_name": "DAVID",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2011-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "38007840",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ME",
"license": "CR580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.