Individual provider Active NPI

Erik Rotterman, MD

  • Psychiatry Physician
  • Owensboro, KY
National Provider Identifier
1073909099
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
52824 Issued in KY
Practice address
1100 Walnut St
Owensboro, KY 42301-2956
Phone
(270) 689-6500
NPI assigned
Apr 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 52824 KY Primary

Addresses

Primary practice location

1100 Walnut St
Owensboro, KY 42301-2956

Mailing address

1100 Walnut St
Owensboro, KY 42301-2956
Phone (270) 689-6500

Other practice location 1

323 E Chestnut St
suite 518
Louisville, KY 40202-1823
Phone (502) 852-3134

Other identifiers 1

IdentifierTypeStateIssuer
7100455490MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191113002034 KY Practitioner - Psychiatry 9436446747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rivervalley Behavioral Health IncGroup PAC ID 4082522396, 22 clinicians

Practice addresses (Care Compare)

1100 Walnut St
Owensboro, KY 42301-2956
Phone (270) 689-6500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52824KYMDPsychiatry Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1073909099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WALNUT ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423012956",
            "telephone_number": "270-689-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WALNUT ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423012956",
            "telephone_number": "270-689-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 E Chestnut St",
            "address_2": "suite 518",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021823",
            "country_code": "US",
            "telephone_number": "502-852-3134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTTERMAN",
        "first_name": "ERIK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "52824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100455490",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.