Scott Edward Omdalen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

486 Issued in ND

Practice address

45 1St Ave SE
Mayville, ND 58257

Phone

(701) 786-4024

Fax

(701) 786-4034

NPI assigned

Sep 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Omdalen Chiropractic Clinic PC

  • Chiropractor
  • Mayville, ND
  • NPI 1346365079
  Medicare reassignment NPD Authorized official
• Van Dam Chiropractic, PC

  • Point of Service
  • Fargo, ND
  • NPI 1205038023
  Medicare reassignment NPD

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376635755",
    "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": {
        "last_name": "OMDALEN",
        "first_name": "SCOTT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16235",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "24295",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Rexine OD PC (Eyes On Broadway)
• Timothy Obrien, LAT, ATC
• Patricia Marie Ogburn
• Inez Marie Olson, LPN
• Omdalen Chiropractic Clinic PC
• Orofacial Myology Consulting
• Jane Ostlie, MD
• Tami K Parker, PT
• Michael Kenneth Rexine, OD
• Carolyn Rygg

• 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 Jul 8, 2007; 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.