Active NPI
James McBride Ottesen, PH.D.
- Clinical Psychologist
- St George, UT
National Provider Identifier
1831102490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 96-325458-2501
- Practice address
- 640 E 700 S
Suite 207
St George, UT 84770-4023 - Phone
- (435) 652-0322
- Fax
- (435) 652-0350
- NPI assigned
- Aug 14, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 96-325458-2501 | UT | Primary |
Addresses
Primary practice location
640 E 700 S
Suite 207
St George, UT 84770-4023
Mailing address
640 E 700 S
Suite 207
St George, UT 84770-4023
Phone (435) 652-0322
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
640 E 700
Suite 207
St George, UT 84770-5732
Phone (435) 652-0322
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 96-325458-2501 | UT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James M Ottesen PHD Inc | Clinical | Current | Accepting new patients |
Locations
640 E 700 S
Ste 207
St George, UT 84770
Phone (435) 628-2718
Organizations & group practices 1
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.
-
- Clinical Psychologist
- St. George, UT
- NPI 1720186307
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831102490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 E 700 S",
"address_2": "SUITE 207",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847704023",
"telephone_number": "435-652-0322",
"fax_number": "435-652-0350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 E 700 S",
"address_2": "SUITE 207",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847704023",
"telephone_number": "435-652-0322",
"fax_number": "435-652-0350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTESEN",
"first_name": "JAMES",
"middle_name": "MCBRIDE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "96-325458-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St George, UT
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.