Ashley Ott OD LLC

Key facts

NPI

1033745773

Entity type

Organization (NPI type 2)

Primary specialty

Optometrist 152W00000X

Legal business name

ASHLEY OTT OD LLC

Practice address

21530 Professional Dr Ste D
Robertsdale, AL 36567-9911

Phone

(251) 975-7507

NPI assigned

Mar 13, 2020

Organization subpart

No

Authorized official

Name

Dr. Ashley Ott, OD NPI 1215290689

Title

President

Phone

(251) 973-6040

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

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

• Ashley McKain Ott, O.D. Optometrist · Robertsdale, AL · NPI 1215290689
  Medicare reassignment Care Compare group NPD Authorized official AL · OPTOMETRIST
• Breanna Kahle, OD Optometrist · Plainfield, IL · NPI 1760008312
  Medicare reassignment Care Compare group NPD AL · OPTOMETRIST

Medicare participation

Medicare fee-for-service enrollment

Enrolled in AL

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• ROBERTSDALE EYE CARE Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 18, 2021.

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1033745773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21530 PROFESSIONAL DR STE D",
            "city": "ROBERTSDALE",
            "state": "AL",
            "postal_code": "365679911",
            "telephone_number": "251-973-6040",
            "fax_number": "251-973-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21530 PROFESSIONAL DR STE D",
            "city": "ROBERTSDALE",
            "state": "AL",
            "postal_code": "365679911",
            "telephone_number": "251-975-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLEY OTT OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-13",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-973-6040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROBERTSDALE EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ROBERTSDALE EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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All providers in Robertsdale, AL · Optometrist in Alabama