James Paul Otteson, PH.D., LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4284 Issued in MN

Practice address

209 E Mill St
Owatonna, MN 55060-3008

Phone

(507) 446-0002

Fax

(507) 451-8003

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1457491110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 E MILL ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550603008",
            "telephone_number": "507-446-0002",
            "fax_number": "507-451-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 E MILL ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550603008",
            "telephone_number": "507-446-0002",
            "fax_number": "507-451-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTESON",
        "first_name": "JAMES",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4284",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MN",
            "license": "LP4284",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "048L8OT",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PSYCHOLOGIST",
            "identifier": "LP4284",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Owatonna Dental Care
• Owatonna Endodontics, LLC

• Clinical Psychologist in Owatonna, MN
• Providers in Owatonna, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; 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.