Individual provider Active NPI

Robert Otto, MSW, LMSW, MA

  • Clinical Social Worker
  • Iowa City, IA
National Provider Identifier
1205360054
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
072637 Issued in IA
Practice address
520 10TH Ave Ste B
Iowa City, IA 52241-1910
Phone
(319) 688-3333
NPI assigned
Apr 19, 2017
Last updated
Apr 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 072637 IA Primary

Addresses

Primary practice location

520 10TH Ave Ste B
Iowa City, IA 52241-1910

Mailing address

520 10TH Ave Ste B
Iowa City, IA 52241-1910

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
072637IAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1205360054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 10TH AVE STE B",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522411910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 10TH AVE STE B",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522411910",
            "telephone_number": "319-688-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "ROBERT",
        "credential": "MSW, LMSW, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "072637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.