Rockwood Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

199913565 Issued in MO

Legal business name

ROCKWOOD FAMILY MEDICINE LLC

Practice address

1747 Smizer Station Rd
Suite 3B
Fenton, MO 63026-2784

Phone

(636) 529-9595

Fax

(636) 529-9494

NPI assigned

Apr 1, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Larry Lee Oteham, D.O.NPI 1700852639

Title

Owner

Phone

(636) 529-9595

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Larry L. Oteham, D.O.

  • Family Medicine Physician
  • Somerset, KY
  • NPI 1700852639
  NPD (past) Authorized official

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229472000000",
    "number": "1023280856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 SMIZER STATION RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262784",
            "telephone_number": "636-529-9595",
            "fax_number": "636-529-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 SMIZER STATION RD",
            "address_2": "SUITE 3B",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262784",
            "telephone_number": "636-529-9595",
            "fax_number": "636-529-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKWOOD FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-12-17",
        "status": "A",
        "authorized_official_last_name": "OTEHAM",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-529-9595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "199913565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George H. Rezabek, D.O.
• Jennifer Kay Rhodes, PHARMD
• Andrew Richardson, CRNA
• Mark D Rickmeyer, D.O.
• Kathleen M Robbins, CLC
• Wendy Kaye Roe, RPH.
• Christina Lynn Roeder, FNP-C
• Laura Ann Rogers, CFNP
• Felice Ann Rolnick, MD
• Sasha E Roschnafsky, DPT

• Family Medicine Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; 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.