Otis Prestige

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

OTIS PRESTIGE

Practice address

109 Anderson St SE Ste 200a
Marietta, GA 30060-8610

Phone

(470) 301-8528

NPI assigned

Jul 25, 2022

Organization subpart

No

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

Authorized official

Name

Damian Drago, ARNP

Title

Administrator

Phone

(470) 301-8528

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1992431753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 ATLANTA ST SE STE 101",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601977",
            "telephone_number": "470-301-8528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 ANDERSON ST SE STE 200A",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608610",
            "telephone_number": "470-301-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTIS PRESTIGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "DRAGO",
        "authorized_official_first_name": "DAMIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "470-301-8528",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "4703018528",
            "identifier": "4703018528",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "4703018528",
            "affiliation": "N",
            "endpointDescription": "contact",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "109 Anderson St SE Ste 200A",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300608610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Oss Care & Consulting, LLC
• Jeanette Lynn Ostell, MASSAGE THERAPIST
• Patrick Jacob Oster, D. C.
• Andrew Kenneth Ostrowski, M.D.
• Jennifer Inglis Oswald, M.A.
• Benjamin Alexander Ott
• Brittany Ott
• Deborah Patterson Ott, NP
• Destiny Ottinot, RN, BSN
• Inemesit Udo Otummkpo, PMHNP

• Infectious Disease Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Infectious Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.