Active NPI
C. Joe Ottinger, M.D.
- Neurology Physician
- Fort Wayne, IN
National Provider Identifier
1952308140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 01023383A
- Practice address
- 7956 W Jefferson Blvd
Fort Wayne, IN 46804-4140 - Phone
- (260) 436-2416
- Fax
- (260) 436-9662
- NPI assigned
- Jul 1, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 01023383A | IN | Primary |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 01023383A | IN |
Addresses
Primary practice location
7956 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Mailing address
7956 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 436-2416
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100096120 | Medicaid | IN | |
| 2717847 | Medicaid | MI | |
| 130005977 | Other | IN | RR MEDICARE |
| 0295872 | Medicaid | OH |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01023383A | IN | MD | Neurology with Special Qualifications in Child Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415577600000",
"number": "1952308140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7956 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044140",
"telephone_number": "260-436-2416",
"fax_number": "260-436-9662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7956 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044140",
"telephone_number": "260-436-2416",
"fax_number": "260-436-9662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTINGER",
"first_name": "C.",
"middle_name": "JOE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-01",
"last_updated": "2014-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IN",
"license": "01023383A",
"primary": true
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "IN",
"license": "01023383A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100096120",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2717847",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "130005977",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0295872",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.