Tyler Odell, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6161-12 Issued in WI

Practice address

237 E Main St
Twin Lakes, WI 53181-9681

Phone

(630) 414-2435

NPI assigned

Feb 2, 2024

Last updated

Feb 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, MI2 enrollments

Enrollment records 2

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.

• Odell Family Chiropractic

  • Chiropractor
  • Twin Lakes, WI
  • NPI 1093579534
  NPD Authorized official
• Adrian J. Denboer, D.C.

  • Chiropractor
  • Grand Rapids, MI
  • NPI 1417094343
  Medicare reassignment
• Adrian J Denboer

  dba DBC Natural Holistic Health Center, PLLC

  • Chiropractor
  • Grand Rapids, MI
  • NPI 1295914851
  NPD

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1801659743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27W354 FLEMING DR",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901034",
            "telephone_number": "630-414-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 E MAIN ST",
            "city": "TWIN LAKES",
            "state": "WI",
            "postal_code": "531819681",
            "telephone_number": "630-414-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELL",
        "first_name": "TYLER",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6161-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce M. Kempken, D.D.S.
• Nikolai S. Laitamaki, LAT
• Mary Lou Mumford
• Jolene Nieman, DPT
• Odell Family Chiropractic
• Jocelyn Marie Osborne, DPT
• Melinda M Pedersen
• Catherine Teresa Petrocelli, RN
• Antonia Posey, LPC
• Christopher Raasch, NP

• Chiropractor in Twin Lakes, WI
• Providers in Twin Lakes, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.