Individual provider Active NPI

Katie Ann Ott, RD

  • Registered Dietitian
  • Modesto, CA
National Provider Identifier
1467095729
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86062158
Practice address
1552 Coffee Rd Ste 200
Modesto, CA 95355-3122
Phone
(209) 248-7168
Fax
(209) 846-9641
NPI assigned
Oct 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86062158 Primary

Addresses

Primary practice location

1552 Coffee Rd Ste 200
Modesto, CA 95355-3122

Mailing address

1001 Sylvan Ave Ste a
Modesto, CA 95350-1699
Phone (209) 248-7168

Other practice location 1

644 E Harding Way Ste B
Stockton, CA 95204-6103
Phone (209) 244-9191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191231001126 CA Practitioner - Registered Dietitian Or Nutrition Professional 7315371283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1552 Coffee Rd
Suite 200
Modesto, CA 95355-3122
Phone 2092487168151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central California Bariatric Surgery, Partnership CurrentSince Jan 6, 2025 Accepting new patients
Central California Bariatric Surgery a Medical Corporation CurrentSince Nov 3, 2019 Accepting new patients

Locations

1001 Sylvan Ave
Ste A
Modesto, CA 95350
Phone (209) 248-7168

1552 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 248-7168

644 E Harding Way
Stockton, CA 95204

644 E Harding Way
Ste B
Stockton, CA 95204
Phone (209) 244-9191

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1467095729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SYLVAN AVE STE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501699",
            "telephone_number": "209-248-7168",
            "fax_number": "209-846-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 COFFEE RD STE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553122",
            "telephone_number": "209-248-7168",
            "fax_number": "209-846-9641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "644 E Harding Way Ste B",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952046103",
            "country_code": "US",
            "telephone_number": "209-244-9191",
            "fax_number": "209-244-9190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTT",
        "first_name": "KATIE",
        "middle_name": "ANN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-18",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "86062158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.