Individual provider Active NPI

Dennis Michael O'Donnell, D.C.

  • Chiropractor
  • Dubuque, IA
National Provider Identifier
1306995824
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06994 Issued in IA
Practice address
419 N. Grandview Ave.
Ste 200
Dubuque, IA 52001
Phone
(563) 585-0800
NPI assigned
Jan 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 06994 IA Primary

Addresses

Primary practice location

419 N. Grandview Ave.
Ste 200
Dubuque, IA 52001

Mailing address

419 N. Grandview Ave.
Ste 200
Dubuque, IA 52001
Phone (563) 585-0800

Other identifiers 2

IdentifierTypeStateIssuer
0456228MedicaidIA
37997OtherIAWELLMARK

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
06994IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-States Clinic of Chiropractic, P.C. Chiropractor PastSince Apr 30, 2003 Accepting new patients
Lynch Chiropractic PLLC Past Accepting new patients
Odonnells Frame Body Chiropractic PastSince Sep 15, 2010 Accepting new patients

Organizations & group practices 3

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306995824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 N. GRANDVIEW AVE.",
            "address_2": "STE 200",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "52001",
            "telephone_number": "563-585-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 N. GRANDVIEW AVE.",
            "address_2": "STE 200",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "52001",
            "telephone_number": "563-585-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "DENNIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0456228",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "37997",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.