Kyle Steven Odonnell, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH61341249 Issued in WA

Practice address

801 S Ruby St Ste 1
Ellensburg, WA 98926-3751

Phone

(509) 962-8008

NPI assigned

Jul 26, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Central Washington Chiropractic IncGroup PAC ID 1052590411, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Central Washington Chiropractic Inc.

  • Health Service Clinic/Center
  • Ellensburg, WA
  • NPI 1790087278
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1285360966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S RUBY ST STE 1",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263751",
            "telephone_number": "509-962-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S RUBY ST STE 1",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263751",
            "telephone_number": "509-962-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONNELL",
        "first_name": "KYLE",
        "middle_name": "STEVEN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61341249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kodi Null
• Andrew Masato Numa, BSCPHARM
• Timothy J O'Brien, MD
• Amy O'Donnell
• Jennifer Krista Obeid-Campbell, MS LMHC
• Dana Michel Ogan
• Erin Olander, ARNP
• Carol H Oldham, R.N.
• Isabelle Oliver
• Robin Olson Mayberry, LMP

• Chiropractor in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.