Active NPI
Nancy Lynn Kottraba, O.D.
- Optometrist
- Madison, WI
National Provider Identifier
1295947927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2685
- Practice address
- 6658 Odana Road
Madison, WI 53719 - Phone
- (608) 829-1818
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2685 | WI | Primary |
Addresses
Primary practice location
6658 Odana Road
Madison, WI 53719
Mailing address
100 Wisconsin Avenue
Unit 503
Madison, WI 53703
Phone (608) 225-5981
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2685 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295947927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WISCONSIN AVENUE",
"address_2": "UNIT 503",
"city": "MADISON",
"state": "WI",
"postal_code": "53703",
"telephone_number": "608-225-5981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6658 ODANA ROAD",
"city": "MADISON",
"state": "WI",
"postal_code": "53719",
"telephone_number": "608-829-1818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTTRABA",
"first_name": "NANCY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "2685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.