Cathy Lynn Otis, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT0000002379 Issued in TN

Practice address

500 Lebanon Valley Church Rd
Cleveland, TN 37311-8477

Phone

(423) 310-0555

Fax

(423) 479-4421

NPI assigned

Apr 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Therapeutic Rehab Services

  • Physical Therapy Clinic/Center
  • Cleveland, TN
  • NPI 1164634820
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1336363126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LEBANON VALLEY CHURCH RD",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373118477",
            "telephone_number": "423-310-0555",
            "fax_number": "423-479-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LEBANON VALLEY CHURCH RD",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373118477",
            "telephone_number": "423-310-0555",
            "fax_number": "423-479-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "CATHY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "OT2379",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "OT0000002379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NO",
            "identifier": "4130281",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5441019",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN MEDICAL LICENSE",
            "identifier": "OT2379",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optical Boutique Associates, LLC
• Optimal Behavioral, LLC
• Optimal Spine Chiropractic PLLC
• Osakaya Inc
• James M Osborn, M.D.
• Lenn Kevin Otto, CRNA
• Outreach Medical Supplies,Inc
• Bridgette Owen, MA
• Juie M Owen
• Mark Winfield Owen, APRN

• Occupational Therapist in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.