Dr. Kaye B. Otter,P.a.

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

1763 Issued in MN

Legal business name

DR. KAYE B. OTTER,P.A.

Practice address

8100 Penn Ave S
Ste 103
Bloomington, MN 55431-1360

Phone

(952) 303-5182

Fax

(952) 303-5182

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kaye Bradley Otter, D.C.

Title

President

Phone

(612) 827-2651

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285545600000",
    "number": "1407079312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 PENN AVE S",
            "address_2": "STE 103",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311360",
            "telephone_number": "952-303-5182",
            "fax_number": "952-303-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 PENN AVE S",
            "address_2": "STE 103",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311360",
            "telephone_number": "952-303-5182",
            "fax_number": "952-303-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KAYE B. OTTER,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2010-09-27",
        "status": "A",
        "authorized_official_last_name": "OTTER",
        "authorized_official_first_name": "KAYE",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-827-2651",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "MN",
            "license": "1763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "765327100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Chiropractor in Bloomington, MN
• Providers in Bloomington, MN by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.