NPIMap

Individual provider Active NPI

Michael D Ottney, D.O.

  • Family Medicine Physician
  • Danville, IL
National Provider Identifier
1558460477
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036102790 Issued in IL
Practice address
707 N Logan Ave
Danville, IL 61832-4360
Phone
(217) 477-4748
Fax
(217) 444-4966
NPI assigned
Sep 21, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036102790 IL
Family Medicine Physician 207Q00000X 036102790 IL Primary

Addresses

Primary practice location

707 N Logan Ave
Danville, IL 61832-4360

Mailing address

707 N Logan Ave
Danville, IL 61832-4360
Phone (217) 477-4748

Other practice location 1

209 NW 11th St
Fairfield, IL 62837-1218
Phone (618) 842-4470 ext. 322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050127000441 IL Practitioner - Family PracticePractitioner - Emergency Medicine 2860442852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital AssociationGroup PAC ID 0244134682, 39 clinicians

Practice addresses (Care Compare)

1454 N County Rd
Suite 2050
Carthage, IL 62321-0160
Phone (217) 357-8500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Memorial Hospital Association Current Accepting new patients
Memorial Hospital Association CurrentSince Oct 1, 2022 Accepting new patients
Memorial Hospital Association CurrentSince Oct 1, 2022 Accepting new patients
Memorial Hospital Association Current Accepting new patients
Memorial Hospital Association Past Accepting new patients
Hoopeston Emergency Medicine Specialists, LTD. Emergency Medicine Past Accepting new patients
Decatur Emergency Medical Services II S C Past Accepting new patients

Locations

209 E 5th St
Bowen, IL 62316
Phone (217) 842-5211

1450 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-2173

1454 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-3131

630 Locust St
Carthage, IL 62321
Phone (217) 357-2173

1471 Keokuk St
Hamilton, IL 62341
Phone (217) 847-3383

501 E Main St
La Harpe, IL 61450
Phone (217) 659-3844

Interoperability endpoints

  • Direct secure messaging: mottney910561@direct.unitypoint.org

Organizations & group practices 8

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

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1558460477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324360",
            "telephone_number": "217-477-4748",
            "fax_number": "217-444-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324360",
            "telephone_number": "217-477-4748",
            "fax_number": "217-444-4966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 NW 11th St",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "IL",
            "postal_code": "628371218",
            "country_code": "US",
            "telephone_number": "618-842-4470 x322",
            "fax_number": "618-842-3437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTNEY",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036102790",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036102790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

Verify at the official NPI Registry.