NPIMap

Individual provider Active NPI

Christina Otterness, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • Bolivar, MO
National Provider Identifier
1992091284
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2016014757 Issued in MO
Practice address
1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone
(417) 328-6036
Fax
(417) 328-6039
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X 2016014757 MO
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 2016014757 MO Primary

Addresses

Primary practice location

1500 N Oakland Ave
Bolivar, MO 65613-3011

Mailing address

1500 N Oakland Ave
Bolivar, MO 65613-3099
Phone (417) 328-6036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180712001432 MO Practitioner - Pathology 4183970775 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2016014757MOMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Single Specialty CurrentSince Dec 2, 2024 Accepting new patients
Citizens Memorial Healthcare Single Specialty CurrentSince Oct 6, 2022 Accepting new patients
Citizens Memorial Hospital District CurrentSince Jul 2, 2018 Accepting new patients
Citizens Memorial Healthcare CurrentSince Oct 6, 2022 Accepting new patients
Citizens Memorial Hospital District Single Specialty CurrentSince Jul 2, 2018 Accepting new patients
Mercy Clinic Springfield Communities Single Specialty CurrentSince Nov 26, 2024 Accepting new patients
Mercy Clinic Springfield Communities Single Specialty CurrentSince Nov 26, 2024 Accepting new patients

Locations

1145 N Butterfield Rd
Bolivar, MO 65613
Phone (417) 777-8115

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Organizations & group practices 7

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1992091284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133099",
            "telephone_number": "417-328-6036",
            "fax_number": "417-328-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-328-6036",
            "fax_number": "417-328-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERNESS",
        "first_name": "CHRISTINA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "MO",
            "license": "2016014757",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2016014757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.