Kristen Otto, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MZ00145500 Issued in NJ

Practice address

268 Southview Dr
Delran, NJ 08075-1924

Phone

(856) 979-2719

NPI assigned

Mar 25, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Advanced Spine and Pain LLC

  • Interventional Pain Medicine Physician
  • Hammonton, NJ
  • NPI 1730359084
  NPD (past)

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1669009023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 SOUTHVIEW DR",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080751924",
            "telephone_number": "856-979-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 SOUTHVIEW DR",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080751924",
            "telephone_number": "856-979-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "KRISTEN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00145500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "SOAP",
            "affiliation": "N",
            "address_1": "268 Southview Dr",
            "city": "Delran",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080751924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• New Jersey CVS Pharmacy LLC
• Laura Norton-Mason, ED.S
• Oaks Integrated Care
• Chike W Obianwu, MD,MBA,FACOG,FACS
• George Olesky, RPH
• Jacquelyn Owens, FNP-C
• Michelle Mosesson Page, PT
• Arijana Painter
• Kavitha Paranjothi, PT, DPT
• Deep Parikh

• Acupuncturist in Delran, NJ
• Providers in Delran, NJ by specialty
• Acupuncturist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.

Verify at the official NPI Registry.