Active NPI
Jonathan Otten, ND
- Naturopath
- White Bear Lake, MN
National Provider Identifier
1992224232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 1061
- Practice address
- 4657 White Bear Pkwy
White Bear Lake, MN 55110-3300 - Phone
- (651) 493-1845
- Fax
- (651) 243-4232
- NPI assigned
- Sep 19, 2017
- 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 |
|---|---|---|---|---|
| Naturopath | 175F00000X | 1061 | MN | Primary |
Addresses
Primary practice location
4657 White Bear Pkwy
White Bear Lake, MN 55110-3300
Mailing address
4657 White Bear Pkwy
White Bear Lake, MN 55110-3300
Phone (651) 493-1845
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628553600000",
"number": "1992224232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4657 WHITE BEAR PKWY",
"city": "WHITE BEAR LAKE",
"state": "MN",
"postal_code": "551103300",
"telephone_number": "651-493-1845",
"fax_number": "651-243-4232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4657 WHITE BEAR PKWY",
"city": "WHITE BEAR LAKE",
"state": "MN",
"postal_code": "551103300",
"telephone_number": "651-493-1845",
"fax_number": "651-243-4232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTEN",
"first_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "ND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-19",
"last_updated": "2021-08-10",
"certification_date": "2021-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "MN",
"license": "1061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Bear Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.