Active NPI
Jesse Jonathan Odell, DC
- Chiropractor
- Buffalo, NY
National Provider Identifier
1962054742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X013265-01
- Practice address
- 295 Main St
Buffalo, NY 14203-2412 - Phone
- (716) 322-0290
- Fax
- (716) 322-0361
- NPI assigned
- Jul 12, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X013265-01 | NY | Primary |
Addresses
Primary practice location
295 Main St
Buffalo, NY 14203-2412
Mailing address
295 Main St
Buffalo, NY 14203-2412
Phone (716) 322-0290
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X013265-01 | NY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western New York Spine & Chiropractic PLLC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Buffalo, NY
- NPI 1336525484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562889600000",
"number": "1962054742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "295 MAIN ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142032412",
"telephone_number": "716-322-0290",
"fax_number": "716-322-0361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 MAIN ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142032412",
"telephone_number": "716-322-0290",
"fax_number": "716-322-0361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODELL",
"first_name": "JESSE",
"middle_name": "JONATHAN",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-12",
"last_updated": "2019-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X013265-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.