Larry Don Otwell, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

L0046123 Issued in OK

Practice address

317 W Cherokee Ave
Suite B
Enid, OK 73701-5615

Phone

(888) 573-7792

Fax

(888) 573-7792

NPI assigned

Apr 1, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Millennium Community Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Enid, OK
  • NPI 1013309616
  NPD (past)

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1093100596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 W ELM AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737034208",
            "telephone_number": "580-478-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W CHEROKEE AVE",
            "address_2": "SUITE B",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015615",
            "telephone_number": "888-573-7792",
            "fax_number": "888-573-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTWELL",
        "first_name": "LARRY",
        "middle_name": "DON",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-01",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "L0046123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Osu Center for Health Sciences (Osu-Aj Integris Women's Health Enid)
• Osu Center for Health Sciences (Osu-Aj Enid Uro Asso Inc)
• Osu Center for Health Sciences (Osu-Aj Integris Bass Baptist Health-Enid)
• Osu Center for Health Sciences (Osu-Aj Integris Bass Baptist Health Center-ER)
• Osu Center for Health Sciences (Osu-Aj St. Mary's Pediatrics)
• Matthew D Ousley
• Lura Jean Owen, MAPM
• Barbara Ann Owens, NP-C
• Michael C Owens, DO
• Joni M Pabelick

• Licensed Practical Nurse in Enid, OK
• Providers in Enid, OK by specialty
• Licensed Practical Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.