Timothy E Odom, D. C.

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

DC5994 Issued in TX

Practice address

5521 Bellaire Dr S
Ste. 100
Fort Worth, TX 76109-8838

Phone

(817) 723-4441

Fax

(817) 732-2472

NPI assigned

Jul 19, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothy.odom@ntiawp-tx.direct.office.nextgen.com

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.

• North Texas Injury and Wellness PLLC

  • Physical Medicine & Rehabilitation Physician
  • Benbrook, TX
  • NPI 1700428901
  Medicare reassignment NPD Authorized official
• Bronson Clinic, Inc.

  • Orthopedic Chiropractor
  • Fort Worth, TX
  • NPI 1225231715
  NPD (past)
• Dr. Brian Mulhall, PA

  dba Active Spine & Sport Therapy

  • Sports Physician Chiropractor
  • Fort Worth, TX
  • NPI 1841389293
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1952320756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5521 BELLAIRE DR S",
            "address_2": "STE. 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761098838",
            "telephone_number": "817-723-4441",
            "fax_number": "817-732-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5521 BELLAIRE DR S",
            "address_2": "STE. 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761098838",
            "telephone_number": "817-723-4441",
            "fax_number": "817-732-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "TIMOTHY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "TX",
            "license": "DC5994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2306040318",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Odette Tomlinson, LPC-S Counseling PLLC
• Roy T Odhner, MA
• Clara Ifeyinwa Odili, NP
• Joseph Odion, PMHNP
• Odom Chiropractic Clinic
• Friday Odomore, FNP
• Lindsay M Oehlkers, PHARMD
• Kwan K Oei, MD
• Tracy L Oeller, PA
• Caitlin C. Oetken, PA-C

• Orthopedic Chiropractor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Orthopedic Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.