Organization Active NPI

Odum Chiropractic Clinic PLLC

  • Chiropractor
  • Oklahoma City, OK
National Provider Identifier
1346349255
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ODUM CHIROPRACTIC CLINIC PLLC
Practice address
1004 NW 150TH
Oklahoma City, OK 73013-0000
Phone
(405) 286-9977
Fax
(405) 286-9979
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Brett Odum, PLLC
Title
Dr. Brett Odum PLLC
Phone
(405) 286-9977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1004 NW 150TH
Oklahoma City, OK 73013-0000

Mailing address

1004 NW 150TH
Oklahoma City, OK 73013
Phone (405) 286-9977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070112000035 OK Part B Supplier - Clinic/Group Practice 5395745582 Receives reassigned benefits from 1 practitioner
Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Locations

15100 Traditions Blvd
Ste 1
Edmond, OK 73013
Phone (405) 509-6483

15100 Traditions Blvd
Edmond, OK 73013

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346349255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 NW 150TH",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-286-9977",
            "fax_number": "405-286-9979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 NW 150TH",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "730130000",
            "telephone_number": "405-286-9977",
            "fax_number": "405-286-9979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODUM CHIROPRACTIC CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ODUM",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "DR. BRETT ODUM PLLC",
        "authorized_official_telephone_number": "405-286-9977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PLLC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.