Tammy Lea Otero, LADC/MH

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1442 Issued in OK

Practice address

12501 W Fountain Rd
Tonkawa, OK 74653-4427

Phone

(505) 263-1731

NPI assigned

Aug 13, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• White Eagle Health Center

  • Clinic/Center
  • Ponca City, OK
  • NPI 1699875724

  OK

  Medicare reassignment NPD
• White Eagle Health Center

  • Substance Abuse Rehabilitation Facility
  • Ponca City, OK
  • NPI 1265271910
  NPD
• White Eagle Health Center

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Ponca City, OK
  • NPI 1891999157
  NPD (past)

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1376199596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 W FOUNTAIN RD",
            "city": "TONKAWA",
            "state": "OK",
            "postal_code": "746534427",
            "telephone_number": "505-263-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 W FOUNTAIN RD",
            "city": "TONKAWA",
            "state": "OK",
            "postal_code": "746534427",
            "telephone_number": "505-263-1731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "827 E Hubbard Rd",
            "address_purpose": "LOCATION",
            "city": "Ponca City",
            "state": "OK",
            "postal_code": "746011156",
            "country_code": "US",
            "telephone_number": "505-263-1731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTERO",
        "first_name": "TAMMY",
        "middle_name": "LEA",
        "credential": "LADC/MH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "1442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jana K Miller
• Northern Oklahoma Family Care
• Northern Oklahoma Pharmacy
• Northern Oklahoma Pharmacy
• Northern Oklahoma Urgent Care
• Terry Parton
• Brittany Perkins
• Shayla Pham
• Megan Nicole Preston
• Ronald R Walcher MD Inc

• All providers in Tonkawa, OK
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.