Individual provider Active NPI

Linda Laverne Ottley, NP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1629085576
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8832 Issued in CA
Practice address
632 Broadway PH
New York, NY 10012-2614
Phone
(800) 731-4254
NPI assigned
Aug 2, 2006
Last updated
Oct 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8832 CA Primary
Nurse Practitioner 363L00000X AP104217 TX
Nurse Practitioner 363L00000X 5647 MN
Nurse Practitioner 363L00000X 14443 CT
Nurse Practitioner 363L00000X R0132242 OK
Nurse Practitioner 363L00000X RN2310658 MA
Family Nurse Practitioner 363LF0000X APRN11022481 FL
Adult Health Nurse Practitioner 363LA2200X 8832 CA
Family Nurse Practitioner 363LF0000X SP033398 PA
Family Nurse Practitioner 363LF0000X R088414 MD
Family Nurse Practitioner 363LF0000X RN286333 GA
Nurse Practitioner 363L00000X 879334 NV

Addresses

Primary practice location

632 Broadway PH
New York, NY 10012-2614

Mailing address

8472 Via Sonoma Unit 30
La Jolla, CA 92037-2735
Phone (760) 212-5172

Other names 1

  • Linda Laverne Rustin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, PA, WV, VA, OH, IN7 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
I20200418000088 DC Practitioner - Nurse Practitioner 1658337183 Reassigns benefits to 1 organization
I20200508002483 MD Practitioner - Nurse Practitioner 1658337183 Reassigns benefits to 1 organization
I20251025000591 PA Practitioner - Nurse Practitioner 1658337183 Reassigns benefits to 1 organization
I20251212001066 WV Practitioner - Nurse Practitioner 1658337183 Reassigns benefits to 1 organization
I20260114002737 VA Practitioner - Nurse Practitioner 1658337183 Reassigns benefits to 1 organization
I20260223002455 OH Practitioner - Nurse Practitioner 1658337183 Reassigns benefits to 1 organization
I20260406000515 IN Practitioner - Nurse Practitioner 1658337183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Post Acute Telehealth PCGroup PAC ID 9638585391, 63 clinicians

Practice addresses (Care Compare)

100 Heartland Dr
Beckley, WV 25801-2655
Phone (304) 256-1650

100 Hresan Blvd
Fayetteville, WV 25840-1333
Phone (304) 574-0770

100 Laurel Dr
Elkton, MD 21921-5328
Phone (410) 398-8800

100 Pkwy Dr
Clarksburg, WV 26301-4357
Phone (304) 624-6401

101 Potters LN
Clarksville, IN 47129-1017
Phone (812) 948-0808

105 Time SQ
Salisbury, MD 21801-2808
Phone (410) 749-2474

1053 Clinic Dr
Ivydale, WV 25113-8266
Phone (304) 286-4204

10797 Seneca TRL S
Lindside, WV 24951-7345
Phone (304) 753-4332

1115 Maplewood Ave
Lewisburg, WV 24901-9728
Phone (304) 645-3076

1209 Indiana Ave
Saint Marys, OH 45885-1310
Phone (419) 394-7611

1217 W Fayette St
Fayette Health and Rehabilitation Cen
Baltimore, MD 21223-1938
Phone (410) 727-3947

1234 Washington Rd
Westminster Healthcare Center
Westminster, MD 21157-5854
Phone (410) 848-0700

1263 S George St
Charles Town, WV 25414-4384
Phone (304) 725-6575

1275 Southview Dr
Bluefield, WV 24701-4347
Phone (304) 325-5448

144 Washington Rd
South River Healthcare Center
Edgewater, MD 21037-1412
Phone (410) 956-5000

150 Venus Rd
Gary, WV 24836-0220
Phone (304) 448-2121

1600 27TH St
Parkersburg, WV 26101-2815
Phone (304) 485-6476

1717 Skyline Dr
Pittsburgh, PA 15227-1744
Phone (412) 885-8400

18086 St RT
Suite 55
Baker, WV 26801-0070
Phone (304) 897-5903

183 Holbrook Rd
Buckhannon, WV 26201-0029
Phone (304) 472-3280

18840 Falling Water Rd
Strongsville, OH 44136-4200
Phone (440) 238-1100

1924 Glenwood Park Rd
Princeton, WV 24739-7969
Phone (304) 425-8128

199 Court St
Jane Lew, WV 26378-8548
Phone (304) 884-7811

2 Hospital PLZ
Grafton, WV 26354-1283
Phone (304) 265-0008

200 Monday Dr
Hamlin, WV 25523-1033
Phone (304) 824-3133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2310658MAMDNurse Practitioner
879334NVMDNurse Practitioner
R0132242OKMDNurse Practitioner
AP104217TXMDNurse Practitioner
APRN11022481FLMDFamily Nurse Practitioner
RN286333GAMDFamily Nurse Practitioner
R088414MDMDFamily Nurse Practitioner
SP033398PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Post Acute Telehealth PC Nurse Practitioner CurrentSince Sep 13, 2025 Accepting new patients

Locations

105 Time Sq
Salisbury, MD 21801
Phone (410) 749-2474

1234 Washington Rd
Westminster, MD 21157
Phone (410) 848-0700

4700 Ashwood Dr
Ste 200
Blue Ash, OH 45241
Phone (800) 989-7337

8055 Addison Rd
Masury, OH 44438
Phone (330) 448-2547

905 Tower Rd
Bristol, PA 19007
Phone (215) 785-2109

1717 Skyline Dr
Pittsburgh, PA 15227
Phone (412) 881-6168

287 E South Blvd
Petersburg, VA 23805
Phone (804) 562-6618

100 Heartland Dr
Beckley, WV 25801
Phone (304) 256-1650

183 Holbrook Rd
Buckhannon, WV 26201
Phone (304) 472-3280

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1629085576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8472 VIA SONOMA UNIT 30",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920372735",
            "telephone_number": "760-212-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 BROADWAY PH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122614",
            "telephone_number": "800-731-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTLEY",
        "first_name": "LINDA",
        "middle_name": "LAVERNE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "8832",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP104217",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "5647",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "14443",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R0132242",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2310658",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11022481",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "8832",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP033398",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R088414",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN286333",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "879334",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "RUSTIN",
            "middle_name": "LAVERNE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.