Individual provider Active NPI

Walter C. Otto, PH.D.

  • Audiologist
  • Las Vegas, NV
National Provider Identifier
1508993064
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-138 Issued in NV
Practice address
1750 S Rainbow Blvd Ste 2
Las Vegas, NV 89146-2949
Phone
(702) 363-2336
Fax
(702) 877-3874
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A-138 NV Primary

Addresses

Primary practice location

1750 S Rainbow Blvd Ste 2
Las Vegas, NV 89146-2949

Mailing address

408 Courtney LN
Las Vegas, NV 89107-2429
Phone (702) 363-2336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
A-138NVMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiological Services Inc Audiologist PastSince Oct 1, 2004 Accepting new patients

Organizations & group practices 1

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508993064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 COURTNEY LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072429",
            "telephone_number": "702-363-2336",
            "fax_number": "702-877-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 S RAINBOW BLVD STE 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891462949",
            "telephone_number": "702-363-2336",
            "fax_number": "702-877-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "WALTER",
        "middle_name": "C.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NV",
            "license": "A-138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • 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.