Individual provider Active NPI

Melody Ott, LCSW

  • Clinical Social Worker
  • St Augustine, FL
National Provider Identifier
1225011869
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW6618 Issued in FL
Practice address
248 Southpark Cir E
St Augustine, FL 32086-5137
Phone
(904) 797-5680
Fax
(904) 797-5681
NPI assigned
Nov 29, 2005
Last updated
Apr 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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 SW6618 FL Primary

Addresses

Primary practice location

248 Southpark Cir E
St Augustine, FL 32086-5137

Mailing address

248 Southpark Cir E
St Augustine, FL 32086-5137
Phone (904) 797-5680

Other identifiers 1

IdentifierTypeStateIssuer
Z010NOtherFLBLUE CROSS BLUE SHIELD

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

LicenseStateTypeSpecialty
SW6618FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Townsend & Associates, P.a. Past Accepting new patients
Dr. Steven P. Dingfelder & Assoc., Inc. Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1225011869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 SOUTHPARK CIR E",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865137",
            "telephone_number": "904-797-5680",
            "fax_number": "904-797-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 SOUTHPARK CIR E",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865137",
            "telephone_number": "904-797-5680",
            "fax_number": "904-797-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTT",
        "first_name": "MELODY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Z010N",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.