Active NPI
Wanda Jean Ottinger, PA-C
- Physician Assistant
- Baldwin, MI
National Provider Identifier
1306875604
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(7) exclusion effective Dec 13, 2013.
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601003581
- Practice address
- 525 4TH St
Baldwin, MI 49304-9518 - Phone
- (231) 745-3116
- Fax
- (231) 745-3136
- NPI assigned
- Jul 1, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601003581 | MI | Primary |
Addresses
Primary practice location
525 4TH St
Baldwin, MI 49304-9518
Mailing address
51 Jefferson St
Newaygo, MI 49337-8828
Phone (231) 652-1522
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5601003581 | Other | MI | STATE LIC |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003581 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306875604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 JEFFERSON ST",
"city": "NEWAYGO",
"state": "MI",
"postal_code": "493378828",
"telephone_number": "231-652-1522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 4TH ST",
"city": "BALDWIN",
"state": "MI",
"postal_code": "493049518",
"telephone_number": "231-745-3116",
"fax_number": "231-745-3136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTINGER",
"first_name": "WANDA",
"middle_name": "JEAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601003581",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LIC",
"identifier": "5601003581",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baldwin, MI
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.