Individual provider Active NPI

Braden Douglas O'Dell, DC

  • Chiropractor
  • Highlands Ranch, CO
National Provider Identifier
1245880137
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHR.0008074 Issued in CO
Practice address
630 Plaza Dr Ste 105
Highlands Ranch, CO 80129-2750
Phone
(303) 503-6318
NPI assigned
Sep 12, 2019
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHR.0008074 CO Primary

Addresses

Primary practice location

630 Plaza Dr Ste 105
Highlands Ranch, CO 80129-2750

Mailing address

630 Plaza Dr Ste 105
Highlands Ranch, CO 80129-2750
Phone (303) 503-6318

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240412003288 CO Practitioner - Chiropractic 4385083120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dynactic Chiropractic LLC Chiropractor CurrentSince Feb 21, 2024 Accepting new patients
SW Health LLC PastSince Feb 21, 2024 Accepting new patients

Locations

855 Inca St
Denver, CO 80204
Phone (303) 523-1478

855 Inca St
#4
Denver, CO 80204

630 Plaza Dr
Ste 105
Highlands Ranch, CO 80129
Phone (303) 471-9355

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1245880137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLAZA DR STE 105",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292750",
            "telephone_number": "303-503-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 PLAZA DR STE 105",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292750",
            "telephone_number": "303-503-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "BRADEN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-12",
        "last_updated": "2024-02-21",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR.0008074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.