DR. RANDOLPH CLAY O'DELL (D.C.) – Chiropractor, NPI 1477644375

DR. RANDOLPH CLAY O'DELL (D.C.) is a healthcare provider. based in Walled lake, Michigan. specializing in CHIROPRACTIC. They hold the professional credentials D.C.. They hold a License No. 2301002842 (MI). The NPI Number for DR. RANDOLPH CLAY O'DELL (D.C.) is 1477644375

Main info

Male
Sole Proprietor
50 Years Of Experience
Accepts Medicare Assignment
Name
DR. RANDOLPH CLAY O'DELL (D.C.)
NPI
1477644375
Phone
(248) 624-6111
Address
1183 PONTIAC TRAIL
Enumeration Date
27 September 2006
Last Update Date
9 July 2007

Doctor Profile

Medical School Name
PALMER COLLEGE CHIROPRACTIC - DAVENPORT
Secondary Phone
8106246111
Graduation Year
1976 (50 years ago)
PAC ID
5799751327
Professional Enrollment ID
I20110113000146
Address ID
MI483903138WA1183XTRLX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,876 CHIROPRACTIC in MI

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Provider Addresses for DR. RANDOLPH CLAY O'DELL (D.C.)

  • 1183, North Pontiac Trail, Walled Lake, Oakland County, Michigan, 48390, United States

    WALLED LAKE, MI 48390

    Phone: (248) 624-6111

    Fax: (248) 624-6129

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-01-13

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110113000146IChiropracticMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98941Chiropractic manipulative treatment, 3-4 spinal regions13512$0
View full utilization report →

Insurance plans in this area (ZIP 48390)

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Reviews

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Frequently asked questions

How do payers reference DR. RANDOLPH CLAY O'DELL (D.C.)?
For DR. RANDOLPH CLAY O'DELL (D.C.), use NPI 1477644375 as the unique 10-digit identifier.
Would DR. RANDOLPH CLAY O'DELL (D.C.) appear as active to a payer?
You can treat DR. RANDOLPH CLAY O'DELL (D.C.) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DR. RANDOLPH CLAY O'DELL (D.C.)?
DR. RANDOLPH CLAY O'DELL (D.C.)'s specialty line reads Chiropractor. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. RANDOLPH CLAY O'DELL (D.C.)?
Directory geography for DR. RANDOLPH CLAY O'DELL (D.C.) centers on Walled Lake, Michigan.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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ERIC S DILTS (DC)

Chiropractor
1183, North Pontiac Trail, Walled Lake, Oakland County, Michigan, 48390, United States
NPI: 1750472759