Otogenetics Corporation

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

OTOGENETICS CORPORATION

Practice address

4553 Winters Chapel Rd Ste 100
Atlanta, GA 30360-2703

Phone

(855) 686-4363

Fax

(206) 339-8150

NPI assigned

Jun 2, 2015

Last updated

Jul 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ping Chen, PHD

Title

President

Phone

(404) 512-9616

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1063892396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744284",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744284",
            "telephone_number": "404-512-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4553 WINTERS CHAPEL RD STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303602703",
            "telephone_number": "855-686-4363",
            "fax_number": "206-339-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTOGENETICS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "PING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-512-9616",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison S Oteju
• Adejumobi Otekunrin
• Iyabo O Otekunrin, MD
• Emily Louise Othold, FNP-C
• Emily Otiso
• Austine Otokhile Jr.
• Kathleen M Otoole, PHD
• Karman Michelle Ott, APRN,BC
• Amy Ottensmeyer
• Stephanie Ottimo, NP

• Clinical Medical Laboratory in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.