Individual provider Active NPI

Steven Scott O'Dell, D.C.

  • Chiropractor
  • Longmont, CO
National Provider Identifier
1699812875
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5740 Issued in CO
Practice address
2144 N. Main St.
Unit 3
Longmont, CO 80501-1407
Phone
(303) 678-7170
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

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 5740 CO Primary

Addresses

Primary practice location

2144 N. Main St.
Unit 3
Longmont, CO 80501-1407

Mailing address

2144 N. Main St.
Unit 3
Longmont, CO 80501-1407
Phone (303) 678-7170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070316000074 CO Practitioner - Chiropractic 8224131040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Longmont Spine and Physical Medicine LLCGroup PAC ID 6709023732, 3 clinicians

Practice addresses (Care Compare)

451 21St Ave
Suite a
Longmont, CO 80501-1483
Phone (303) 678-7170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5740COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Longmont Spine and Physical Medicine, LLC CurrentSince Jul 9, 2014 Accepting new patients

Locations

2144 Main St
Ste 3
Longmont, CO 80501
Phone (303) 678-7170

451 21st Ave
Ste A
Longmont, CO 80501
Phone (303) 678-7170

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, 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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699812875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2144 N. MAIN ST.",
            "address_2": "UNIT 3",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011407",
            "telephone_number": "303-678-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2144 N. MAIN ST.",
            "address_2": "UNIT 3",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011407",
            "telephone_number": "303-678-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "STEVEN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

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.
  • 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.