Omdalen Chiropractic Clinic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

OMDALEN CHIROPRACTIC CLINIC PC

Practice address

45 1St Ave SE
Mayville, ND 58257

Phone

(701) 786-4024

Fax

(701) 786-4034

NPI assigned

Mar 20, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Scott Edward Omdalen, D.C.NPI 1376635755

Title

Owner

Phone

(701) 786-4024

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Scott Edward Omdalen, DC

  • Chiropractor
  • Mayville, ND
  • NPI 1376635755
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346365079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 1ST AVE SE",
            "city": "MAYVILLE",
            "state": "ND",
            "postal_code": "58257",
            "telephone_number": "701-786-4024",
            "fax_number": "701-786-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 1ST AVE SE",
            "city": "MAYVILLE",
            "state": "ND",
            "postal_code": "58257",
            "telephone_number": "701-786-4024",
            "fax_number": "701-786-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMDALEN CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OMDALEN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-786-4024",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS GROUP",
            "identifier": "01210001",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16235",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James G Mehus, MD
• Michael Rexine OD PC (Eyes On Broadway)
• Timothy Obrien, LAT, ATC
• Patricia Marie Ogburn
• Inez Marie Olson, LPN
• Scott Edward Omdalen, DC
• Orofacial Myology Consulting
• Jane Ostlie, MD
• Tami K Parker, PT
• Michael Kenneth Rexine, OD

• Chiropractor in Mayville, ND
• Providers in Mayville, ND by specialty
• Chiropractor in North Dakota

• 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.