Lottie Renee Rotterman, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

022302 Issued in OR

Practice address

24076 SE Stark St
Suite 230
Gresham, OR 97030-3373

Phone

(503) 465-5461

Fax

(503) 465-5468

NPI assigned

Jul 12, 2007

Last updated

Nov 17, 2021By 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

Other identifiers 2

Other names 1

• Lottie Renee Policar Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1871792580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322684",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST",
            "address_2": "SUITE 230",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-465-5461",
            "fax_number": "503-465-5468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 NE 99th Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972209442",
            "country_code": "US",
            "telephone_number": "503-488-2626",
            "fax_number": "503-488-2630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTTERMAN",
        "first_name": "LOTTIE",
        "middle_name": "RENEE",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "022302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234892",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871792580",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referringeent@orclinic.direct-ci.net",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "24076 SE Stark St",
            "address_2": "Suite 230",
            "city": "Gresham",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970303373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LOTTIE",
            "last_name": "POLICAR",
            "middle_name": "RENEE",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Audiologist in Gresham, OR
• Providers in Gresham, OR by specialty
• Audiologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.