Tia Michelle Ott, SFA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

209275 Issued in MD

Practice address

12502 Willowbrook Rd Ste 500
Cumberland, MD 21502-6572

Phone

(301) 722-8847

NPI assigned

Aug 29, 2023

Last updated

Aug 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1528843307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12405 BUTLER DR NW",
            "city": "LAVALE",
            "state": "MD",
            "postal_code": "215026027",
            "telephone_number": "301-876-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12502 WILLOWBROOK RD STE 500",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215026572",
            "telephone_number": "301-722-8847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12500 Willowbrook Rd",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "MD",
            "postal_code": "215026393",
            "country_code": "US",
            "telephone_number": "240-964-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTT",
        "first_name": "TIA",
        "middle_name": "MICHELLE",
        "credential": "SFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "MD",
            "license": "209275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Assistant in Cumberland, MD
• Providers in Cumberland, MD by specialty
• Surgical Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.