Active NPI
Henry Stuart Otto III, PT
- Physical Therapist
- Midland, MI
National Provider Identifier
1730148164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 006404
- Practice address
- 424 W Wackerly Road
Midland, MI 48640 - Phone
- (989) 631-4100
- Fax
- (989) 631-1154
- NPI assigned
- Mar 23, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 006404 | MI | Primary |
Addresses
Primary practice location
424 W Wackerly Road
Midland, MI 48640
Mailing address
607 Linwood Drive
Midland, MI 48640-6002
Phone (989) 832-5943
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006404 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1730148164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 LINWOOD DRIVE",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406002",
"telephone_number": "989-832-5943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 W WACKERLY ROAD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "48640",
"telephone_number": "989-631-4100",
"fax_number": "989-631-1154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTO",
"first_name": "HENRY",
"middle_name": "STUART",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "006404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.