Individual provider Active NPI

Richard Hal O'Dell II, MD

  • Diagnostic Radiology Physician
  • Oklahoma City, OK
National Provider Identifier
1629035480
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
17921 Issued in OK
Practice address
3330 NW 56TH
Suite 206
Oklahoma City, OK 73112-4426
Phone
(405) 945-4710
Fax
(405) 945-4751
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 17921 OK Primary

Addresses

Primary practice location

3330 NW 56TH
Suite 206
Oklahoma City, OK 73112-4426

Mailing address

3330 NW 56TH
Suite 206
Oklahoma City, OK 73112-4426
Phone (405) 945-4710

Other identifiers 2

IdentifierTypeStateIssuer
100065450AMedicaidOK
P00415260OtherOKMEDICARE RR LLC

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Integris South Oklahoma City Hospital Corporation Past Accepting new patients
Radiology Consultants, PC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1629035480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 NW 56TH",
            "address_2": "SUITE 206",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124426",
            "telephone_number": "405-945-4710",
            "fax_number": "405-265-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 NW 56TH",
            "address_2": "SUITE 206",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124426",
            "telephone_number": "405-945-4710",
            "fax_number": "405-945-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "RICHARD",
        "middle_name": "HAL",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "17921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100065450A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR LLC",
            "identifier": "P00415260",
            "state": "OK"
        }
    ],
    "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 Sep 25, 2014; 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.