Active NPI
Otter Tail Podiatry Associates, P.a.
- Foot Surgery Podiatrist
- Fergus Falls, MN
National Provider Identifier
1639150774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- Legal business name
- OTTER TAIL PODIATRY ASSOCIATES, P.A.
- Practice address
- 120 E Junius Ave
Fergus Falls, MN 56537-2819 - Phone
- (218) 736-6868
- Fax
- (218) 736-6017
- NPI assigned
- Nov 7, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Karenthea W. Rouw, D.P.M.
- Title
- Ceo
- Phone
- (218) 736-6868
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | Primary |
Addresses
Primary practice location
120 E Junius Ave
Fergus Falls, MN 56537-2819
Mailing address
120 E Junius Ave
Fergus Falls, MN 56537-2819
Phone (218) 736-6868
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3B099OT | Other | MN | BCBSMN |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Saint Cloud, MN
- NPI 1003897133
Foot Surgery
-
- Podiatrist
- Alexandria, MN
- NPI 1992785844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1639150774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 E JUNIUS AVE",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565372819",
"telephone_number": "218-736-6868",
"fax_number": "218-736-6017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 E JUNIUS AVE",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565372819",
"telephone_number": "218-736-6868",
"fax_number": "218-736-6017"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OTTER TAIL PODIATRY ASSOCIATES, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-07",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ROUW",
"authorized_official_first_name": "KARENTHEA",
"authorized_official_middle_name": "W.",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "218-736-6868",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.P.M."
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSMN",
"identifier": "3B099OT",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fergus Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.