Active NPI
Leeann Otto
- School Registered Nurse
- Walton, NY
National Provider Identifier
1164973962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- 659932
- Practice address
- 88 Griswold St
Walton, NY 13856 - Phone
- (607) 865-5220
- Fax
- (607) 865-9211
- NPI assigned
- Oct 18, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 659932 | NY | Primary |
Addresses
Primary practice location
88 Griswold St
Walton, NY 13856
Mailing address
42-66 North St.
Walton, NY 13856
Phone (607) 865-5220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 659932 | NY | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476748800000",
"number": "1164973962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42-66 NORTH ST.",
"city": "WALTON",
"state": "NY",
"postal_code": "13856",
"telephone_number": "607-865-5220",
"fax_number": "607-865-9211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 GRISWOLD ST",
"city": "WALTON",
"state": "NY",
"postal_code": "13856",
"telephone_number": "607-865-5220",
"fax_number": "607-865-9211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTO",
"first_name": "LEEANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-18",
"last_updated": "2016-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "NY",
"license": "659932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.