Active NPI
Douglas E Ott, MD
- Gynecology Physician
- Macon, GA
National Provider Identifier
1427260231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- AO9098294
- Practice address
- 2410 Ingleside Ave
Macon, GA 31204-2036 - Phone
- (478) 477-8996
- NPI assigned
- May 4, 2007
- Last updated
- Nov 8, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | AO9098294 | GA | Primary |
Addresses
Primary practice location
2410 Ingleside Ave
Macon, GA 31204-2036
Mailing address
109 Preston CT
Macon, GA 31210-5769
Phone (478) 477-8996
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00255824E | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AO9098294 | GA | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320710400000",
"number": "1427260231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 PRESTON CT",
"city": "MACON",
"state": "GA",
"postal_code": "312105769",
"telephone_number": "478-477-8996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 INGLESIDE AVE",
"city": "MACON",
"state": "GA",
"postal_code": "312042036",
"telephone_number": "478-477-8996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTT",
"first_name": "DOUGLAS",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2011-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "GA",
"license": "AO9098294",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00255824E",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.