Individual provider Active NPI

Katherine D Otto, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1831438902
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-121557 Issued in AL
Practice address
201 Governors Dr SW Ste 400
Huntsville, AL 35801-5183
Phone
(256) 265-7064
Fax
(256) 265-7017
NPI assigned
Feb 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-121557 AL Primary

Addresses

Primary practice location

201 Governors Dr SW Ste 400
Huntsville, AL 35801-5183

Mailing address

PO Box 11407
Birmingham, AL 35246-0116
Phone (256) 533-7064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140606000493 AL Practitioner - Nurse Practitioner 0547484859 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HH Tennessee Valley Pain CenterGroup PAC ID 4587075783, 33 clinicians

Practice addresses (Care Compare)

201 Governors Dr SW
Suite 400
Huntsville, AL 35801-5183
Phone (256) 265-7246

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-121557ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HH Tennessee Valley Pain Center CurrentSince Dec 1, 2020 Accepting new patients
Tennessee Valley Pain Consultants, PC CurrentSince Mar 22, 2017 Accepting new patients

Locations

201 Governors Dr SW
Huntsville, AL 35801
Phone (256) 265-6851

201 Governors Dr SW
Ste 400
Huntsville, AL 35801
Phone (256) 265-7246

201 Governors Dr SW
Fl 4
Huntsville, AL 35801
Phone (256) 265-7246

2009 Gallatin St SW
Huntsville, AL 35801

460 Lanier Rd
Ste 204
Madison, AL 35758
Phone (256) 319-9000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1831438902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352460116",
            "telephone_number": "256-533-7064",
            "fax_number": "256-704-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 GOVERNORS DR SW STE 400",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015183",
            "telephone_number": "256-265-7064",
            "fax_number": "256-265-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "KATHERINE",
        "middle_name": "D",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-08",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-121557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.