Individual provider Active NPI

Annelie Ott, M.D.

  • Family Medicine Physician
  • Dexter, MI
National Provider Identifier
1083900237
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301098564 Issued in MI
Practice address
7093 Dexter Ann Arbor Rd
Dexter, MI 48130-8568
Phone
(734) 426-9028
Fax
(734) 426-9029
NPI assigned
Jun 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301098564 MI
Family Medicine Physician 207Q00000X 4301098564 MI Primary

Addresses

Primary practice location

7093 Dexter Ann Arbor Rd
Dexter, MI 48130-8568

Mailing address

24 Frank Lloyd Wright Dr Lbby J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20141029002361 MI Practitioner - Family Practice 4284855529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

7093 Dexter Ann Arbor Rd
Dexter, MI 48130-8568
Phone (734) 426-8696

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301098564MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince Jun 1, 2020 Accepting new patients
Iha Health Services Corporation Family Medicine CurrentSince Jun 1, 2020 Accepting new patients
Iha Health Services Corporation Family Medicine Past Accepting new patients

Locations

3200 W Liberty Rd
Ste C
Ann Arbor, MI 48103
Phone (734) 761-2581

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

14650 E Old US Highway 12
Ste 101
Chelsea, MI 48118
Phone (734) 475-3979

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

7093 Dexter Ann Arbor Rd
Dexter, MI 48130
Phone (734) 426-8696

Interoperability endpoints

  • Direct secure messaging: aott26123@direct.trinity-health.org

Organizations & group practices 4

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1083900237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR LBBY J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7093 DEXTER ANN ARBOR RD",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481308568",
            "telephone_number": "734-426-9028",
            "fax_number": "734-426-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTT",
        "first_name": "ANNELIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301098564",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301098564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dexter, MI

Sources for this page

Verify at the official NPI Registry.