Individual provider Active NPI

Otis R Barnum, DO

  • Internal Medicine Physician
  • Natchitoches, LA
National Provider Identifier
1245224559
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
018855 Issued in LA
Practice address
617 Bienville St
Natchitoches, LA 71457-5739
Phone
(318) 352-9880
Fax
(318) 357-1347
NPI assigned
Sep 1, 2005
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 018855 LA Primary

Addresses

Primary practice location

617 Bienville St
Natchitoches, LA 71457-5739

Mailing address

617 Bienville St Ste a
Natchitoches, LA 71457-5740
Phone (318) 352-9880

Other identifiers 1

IdentifierTypeStateIssuer
1361984MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040714000189 LA Practitioner - Internal Medicine 2466431564 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
018855LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Natchitoches Parish Hospital Service District CurrentSince Jul 18, 2025 Accepting new patients
Barnum Internal Medicine Internal Medicine CurrentSince Jun 1, 2018 Accepting new patients
Natchitoches Parish Hospital Service District CurrentSince Jul 18, 2025 Accepting new patients
Natchitoches Parish Hospital Service District Past Accepting new patients
Otis R. Barnum ,D.O. Internal Medicine PastSince Apr 1, 2004 Accepting new patients

Locations

1029 Keyser Ave
Ste H
Natchitoches, LA 71457
Phone (318) 238-9880

501 Keyser Ave
Natchitoches, LA 71457
Phone (318) 214-4200

617 Bienville St
Ste A
Natchitoches, LA 71457
Phone (318) 238-4604

Organizations & group practices 5

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1245224559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 BIENVILLE ST STE A",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575740",
            "telephone_number": "318-352-9880",
            "fax_number": "318-357-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 BIENVILLE ST",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575739",
            "telephone_number": "318-352-9880",
            "fax_number": "318-357-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNUM",
        "first_name": "OTIS",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "018855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1361984",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchitoches, LA

Sources for this page

Verify at the official NPI Registry.