NPIMap

Organization Active NPI

Ottumwa Health Group LLC

  • Gynecology Physician
  • Ottumwa, IA
National Provider Identifier
1386956290
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
OTTUMWA HEALTH GROUP LLC
Practice address
1001 Pennsylvania Ave
Ottumwa, IA 52501-2186
Phone
(641) 682-7511
Fax
(641) 684-3199
NPI assigned
Jul 8, 2010
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU
Gynecology Physician 207VG0400X NU Primary
Obstetrics Physician 207VX0000X NU
Orthopaedic Surgery Physician 207X00000X NU
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X NU

Addresses

Primary practice location

1001 Pennsylvania Ave
Ottumwa, IA 52501-2186

Mailing address

1001 Pennsylvania Ave
Ottumwa, IA 52501-2186
Phone (641) 682-7511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100927001257 IA Part B Supplier - Clinic/Group Practice 3971629924 Receives reassigned benefits from 86 practitioners
5 other NPIs on this enrollment
Practice locations: Sigourney, IA; Centerville, IA; Ottumwa, IA; Fairfield, IA; Eddyville, IA; Bloomfield, IA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1011 Pennsylvania Ave
Ste B
Ottumwa, IA 52501
Phone (641) 684-2684

Practitioners & affiliated clinicians

Practitioners 91

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 91

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1386956290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 PENNSYLVANIA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012186",
            "telephone_number": "641-682-7511",
            "fax_number": "641-684-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 PENNSYLVANIA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012186",
            "telephone_number": "641-682-7511",
            "fax_number": "641-684-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTUMWA HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-08",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.