Andrew Ott, LLC
Organization Active NPI Community/Behavioral Health Agency · Columbia City, IN
NPI 1467908012 · NPPES record last updated Sep 1, 2016
Key facts
- NPI
- 1467908012
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 34005694A (IN)
- Legal business name
- ANDREW OTT, LLC
- Practice address
- 402 N. Washington St.
Columbia City, IN 46725 - Phone
- (260) 244-7413
- Fax
- (260) 387-6984
- NPI assigned
- Sep 1, 2016
- Organization subpart
- No
Authorized official
- Name
- Mr. J Andrew Ott, MSW, LCSW
- Title
- Sole Member
- Phone
- (260) 387-6340
Practitioners 1
-
J. Andrew Ott, MSW, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170210000982 | IN | Part B Supplier - Clinic/Group Practice | 4284917543 |
Receives reassigned benefits from 1 practitioner Practice locations: Fort Wayne, IN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 34005694A | IN | Yes |
Addresses
Primary practice location
402 N. Washington St.
Columbia City, IN 46725
Mailing address
402 N. Washington St.
Columbia City, IN 46725
Phone (260) 244-7413
Other names
- Andrew Ott
Other providers in Columbia City, IN
- Babatunde Adeosun
- Alarie Chiropractic Center Inc
- Renel Gerald Alarie
- Cheryl L Allen
- Allied Physicians Inc., D/B/a Tri-State Physical Medicine
- Amanda Kate Atz
- Angelyss Auer
- Kathleen B Baeverstad
- Jessica Baker
- Barbara Beck
All providers in Columbia City, IN · Community/Behavioral Health Agency in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.