Leroy Frank Otto, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1417 Issued in MN

Practice address

127 South High Street
Lake City, MN 55041-1637

Phone

(651) 345-3361

Fax

(651) 345-4049

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Downtown Chiropractic LTD.

  • Chiropractor
  • Red Wing, MN
  • NPI 1538233101
  NPD Authorized official

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497813083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 SOUTH HIGH STREET",
            "city": "LAKE CITY",
            "state": "MN",
            "postal_code": "550411637",
            "telephone_number": "651-345-3361",
            "fax_number": "651-345-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 SOUTH HIGH STREET",
            "city": "LAKE CITY",
            "state": "MN",
            "postal_code": "550411637",
            "telephone_number": "651-345-3361",
            "fax_number": "651-345-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "LEROY",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1417",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1381",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "857CHI",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "36065OT",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Vernon Myers, MD
• Heather Nagel
• Laura Anthony O'Rourke, NP-C
• Christian Howard Oeltjen
• Elizabeth Agnes Olson, D.C.
• Patients First LLC
• Pepin Valley Dental
• Perry Dental, LTD.
• Alan Wayne Peters
• Douglas David Pflaum, M.D.

• Chiropractor in Lake City, MN
• Providers in Lake City, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.