Individual provider Active NPI

Lynda Ellen Otte, RNC-NIC BSN

  • Neonatal Intensive Care Registered Nurse
  • Plymouth Meeting, PA
National Provider Identifier
1023336278
Registry record updated May 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Intensive Care Registered NurseTaxonomy code 163WN0002X
License
R039574 Issued in MD
Practice address
2250 Hickory Rd
Suite240
Plymouth Meeting, PA 19462-1047
Phone
(877) 664-6661
NPI assigned
May 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X R039574 MD Primary

Addresses

Primary practice location

2250 Hickory Rd
Suite240
Plymouth Meeting, PA 19462-1047

Mailing address

3060 New Oak LN
Bowie, MD 20716-1350
Phone (301) 249-4831

Other identifiers 1

IdentifierTypeStateIssuer
R039574OtherMDREGISTERED NURSE

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
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
R039574MDMDNeonatal Intensive Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273622400000",
    "number": "1023336278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 NEW OAK LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161350",
            "telephone_number": "301-249-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 HICKORY RD",
            "address_2": "SUITE240",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621047",
            "telephone_number": "877-664-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTE",
        "first_name": "LYNDA",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "RNC-NIC BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2010-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "MD",
            "license": "R039574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "R039574",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; 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.