Individual provider Active NPI

Nathaniel Ott, M.D.

  • General Practice Physician
  • Dallas, TX
National Provider Identifier
1679983480
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
R1604 Issued in TX
Practice address
810 Turner Ave
Dallas, TX 75208-3737
Phone
(623) 210-6504
NPI assigned
May 1, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X R1604 TX Primary

Addresses

Primary practice location

810 Turner Ave
Dallas, TX 75208-3737

Mailing address

810 Turner Ave
Dallas, TX 75208-3737
Phone (623) 210-6504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160316000452 OK Practitioner - Family Practice 0143449538 Reassigns benefits to 1 organization
I20170928003579 TX Practitioner - Emergency Medicine 0143449538 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Care Consultants Region II Inc CurrentSince Jul 1, 2016 Accepting new patients
West Texas Urgent Care LLC CurrentSince Jun 5, 2018 Accepting new patients
Ott Medical Group PLLC Current Accepting new patients
Concord Medical Group PLLC Current Accepting new patients
West Texas Urgent Care LLC CurrentSince Jun 5, 2018 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Jun 10, 2017 Accepting new patients

Locations

1801 W 3rd St
Elk City, OK 73644
Phone 5802255403677

501 N 14th St
Perry, OK 73077
Phone (580) 336-3541

4438 S Clack St
Ste 200
Abilene, TX 79606
Phone (325) 704-4470

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

303 Sandy Corner Rd
El Campo, TX 77437
Phone (979) 543-6251

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

701 McClintic Dr
Lake Limestone, TX 76642
Phone (254) 729-3281

Interoperability endpoints

  • Direct secure messaging: nathaniel.ott.1@14590.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679983480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 TURNER AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752083737",
            "telephone_number": "623-210-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 TURNER AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752083737",
            "telephone_number": "623-210-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTT",
        "first_name": "NATHANIEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "R1604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.