Individual provider Active NPI

Ryan Jordan Otten, M.D.

  • Occupational Medicine Physician
  • Thornton, CO
National Provider Identifier
1649463407
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
48032 Issued in CO
Practice address
9195 Grant St Ste 100
Thornton, CO 80229-4386
Phone
(303) 292-0034
Fax
(303) 292-0097
NPI assigned
Aug 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 48032 CO Primary

Addresses

Primary practice location

9195 Grant St Ste 100
Thornton, CO 80229-4386

Mailing address

4900 S Monaco St Ste 210
#C
Denver, CO 80237-3487
Phone (303) 292-0034

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 Medicine

State licenses

LicenseStateTypeSpecialty
48032COMDOccupational Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1649463407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MONACO ST STE 210",
            "address_2": "#C",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373487",
            "telephone_number": "303-292-0034",
            "fax_number": "303-292-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9195 GRANT ST STE 100",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294386",
            "telephone_number": "303-292-0034",
            "fax_number": "303-292-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTEN",
        "first_name": "RYAN",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CO",
            "license": "48032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.