Gerald Vincent Otteni, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

19813 Issued in NC

Practice address

212 Lephillip CT., NE
Suite 201
Concord, NC 28025-2977

Phone

(704) 786-0214

Fax

(704) 788-2379

NPI assigned

Mar 21, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1023077807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 LEPHILLIP CT., NE",
            "address_2": "SUITE 201",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252977",
            "telephone_number": "704-786-0214",
            "fax_number": "704-788-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 LEPHILLIP CT., NE",
            "address_2": "SUITE 201",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252977",
            "telephone_number": "704-786-0214",
            "fax_number": "704-788-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTENI",
        "first_name": "GERALD",
        "middle_name": "VINCENT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "19813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8964371",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Concord, NC
• Providers in Concord, NC by specialty
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.