Individual provider Active NPI

David Allen Ott, PH.D.

  • Clinical Psychologist
  • Orlando, FL
National Provider Identifier
1194777037
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7414 Issued in FL
Practice address
5201 Raymond St
Orlando, FL 32803-8208
Phone
(407) 629-1599
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 5478 OH
Clinical Psychologist 103TC0700X 5478 OH
Clinical Child & Adolescent Psychologist 103TC2200X 5478 OH
Forensic Psychologist 103TF0200X 5478 OH
Intellectual & Developmental Disabilities Psychologist 103TM1800X 5478 OH
Psychologist 103T00000X 5478 OH
Cognitive & Behavioral Psychologist 103TB0200X PY7414 FL
Clinical Psychologist 103TC0700X PY7414 FL Primary
Clinical Child & Adolescent Psychologist 103TC2200X PY7414 FL
Forensic Psychologist 103TF0200X PY7414 FL
Intellectual & Developmental Disabilities Psychologist 103TM1800X PY7414 FL
Psychologist 103T00000X PY7414 FL

Addresses

Primary practice location

5201 Raymond St
Orlando, FL 32803-8208

Mailing address

3504 Woodley Park PL
Oviedo, FL 32765-5105
Phone (407) 977-5871

Other identifiers 3

IdentifierTypeStateIssuer
000000347111OtherOHANTHEM
2287047MedicaidOH
298511000OtherOHMAGELLAN

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY7414FLMDClinical Child & Adolescent Psychologist
5478OHMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1194777037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3504 WOODLEY PARK PL",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327655105",
            "telephone_number": "407-977-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 RAYMOND ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328038208",
            "telephone_number": "407-629-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTT",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "OH",
            "license": "5478",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5478",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OH",
            "license": "5478",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "OH",
            "license": "5478",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "OH",
            "license": "5478",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "5478",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY7414",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7414",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY7414",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "FL",
            "license": "PY7414",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "FL",
            "license": "PY7414",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY7414",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000347111",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2287047",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "298511000",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.