Otke-Villa LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

032359 Issued in MO

Legal business name

OTKE-VILLA LLC

Practice address

1030 Edmonds St
Jefferson City, MO 65109-5213

Phone

(573) 635-3381

Fax

(573) 635-6685

NPI assigned

May 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Tom Otke

Title

Member

Phone

(573) 659-6607

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730131897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 EDMONDS ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095213",
            "telephone_number": "573-635-3381",
            "fax_number": "573-635-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 EDMONDS ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095213",
            "telephone_number": "573-635-3381",
            "fax_number": "573-635-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTKE-VILLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OTKE",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "573-659-6607",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "032359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Ryan Orme, DDS
• Janice Orr, LPC
• Tricia Orscheln, LPC
• Elochukwu Anthony Osoego, P.A.
• Christine Diane Oswald, RPH
• Jami Otke
• Our Lady Queen of Peace Center, Inc.
• Ousley Behavior Services, LLC
• Catherine E Ousley, M.ED., L.P.C.
• Outbound Rehabilitation & Wellness LLC (Outbound Physical Therapy & Rehab)

• Skilled Nursing Facility in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Skilled Nursing Facility in Missouri

• 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.

Verify at the official NPI Registry.