Ottendorf Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

OTTENDORF LABORATORIES, LLC

Practice address

1095 Investment Blvd
Apex, NC 27502-1799

Phone

(919) 390-3566

Fax

(919) 629-8402

NPI assigned

Jul 10, 2015

Organization subpart

No

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

Authorized official

Name

Konrad H Kaeding

Title

Sole Owner and Manager

Phone

(302) 593-5904

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1437533254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3922 GISBOURNE DR",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272827706",
            "telephone_number": "302-518-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 INVESTMENT BLVD",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275021799",
            "telephone_number": "919-390-3566",
            "fax_number": "919-629-8402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "839 Majestic Ct Ste 3",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280545152",
            "country_code": "US",
            "telephone_number": "919-390-3566",
            "fax_number": "919-629-8402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OTTENDORF LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "KAEDING",
        "authorized_official_first_name": "KONRAD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "SOLE OWNER AND MANAGER",
        "authorized_official_telephone_number": "302-593-5904"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437533254",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optimum Home Care Agency
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• Benjamin L. Ose, MD
• Grace Ostraco
• Madeline Rose Ostrowski
• Victoria Otto
• Laurin Oxendine-Myers
• Alicia Ozhakanat, PA
• Kendall Panciera, LCSWA
• Aaron Pankiewicz, DO

• Clinical Medical Laboratory in Apex, NC
• Providers in Apex, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.