Jodi Otis, MPT, ATC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

118132 Issued in MO

Practice address

10435 Clayton Rd
Suite 120
Frontenac, MO 63131-2909

Phone

(314) 985-3002

Fax

(314) 985-3012

NPI assigned

Jul 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Gateway Pain Center Inc

  dba Injury Specialists

  • Pain Medicine (Anesthesiology) Physician
  • Frontenac, MO
  • NPI 1568475689
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700811130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD",
            "address_2": "STE. 116E",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418705",
            "telephone_number": "314-985-3002",
            "fax_number": "314-985-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10435 CLAYTON RD",
            "address_2": "SUITE 120",
            "city": "FRONTENAC",
            "state": "MO",
            "postal_code": "631312909",
            "telephone_number": "314-985-3002",
            "fax_number": "314-985-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "JODI",
        "credential": "MPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "118132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren McGaughey, PA-C
• Melanie Melissa Miranda, WHNP-BC
• Nra-St. Louis (Home Therapy Center), Missouri, LLC (Frontenac Home Dialysis Center)
• Nutriformance
• Samantha O'Daniel
• Eleanor Bridget Perkins, LPC, NCC
• Samantha R Porter, PT, DPT, LMT, CMTPT
• Drew Rapert, DC
• Evan J Reed, D.D.S.
• Donald Reeves Respess, PSY.D.

• Orthopedic Physical Therapist in Frontenac, MO
• Providers in Frontenac, MO by specialty
• Orthopedic Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.