David Thomas Ottenbaker, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301047511 Issued in MI

Practice address

1445 Sheldon Rd
Suite 201
Grand Haven, MI 49417-2480

Phone

(616) 846-8540

NPI assigned

Jun 1, 2005

Last updated

Jan 24, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Horizon Medical PC

  • General Practice Physician
  • Grand Haven, MI
  • NPI 1164461943
  Authorized official Same address or phone
• Michigan Medical Patient Care

  • Durable Medical Equipment & Medical Supplies
  • Holland, MI
  • NPI 1871741652
  NPD (past)
• Newaygo County General Hospital Association

  dba Corewell Health Gerber Hospital

  • Critical Access Hospital
  • Fremont, MI
  • NPI 1063836963
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1386648624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 SHELDON RD",
            "address_2": "SUITE 201",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172480",
            "telephone_number": "616-846-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTENBAKER",
        "first_name": "DAVID",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301047511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Osborn, DPT
• Julia Osterman, LLMSW
• Shelley Ostric, MD
• Ottawa County CMH
• Ottawa Shores ENT Associates PC
• Henry Ottens, M.D.
• Kelly Lynn Ouellette, OT
• Out Side in, Inc.
• Nancy L Owens, RN, FNP-C
• Sydney Geri Pacek-Dewey, CCC-SLP

• Family Medicine Physician in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.