MR. JAMIE LOUIS OTTER (NPI# 1356869101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356869101 |
| Entity Type | Individual |
| Full Name | MR. JAMIE LOUIS OTTER |
| Practice Address |
114 Orchard Lake Rd Pontiac MI 48341-2244 |
| Practice Telephone | 2488587766 |
| Practice Fax Number | 2488587258 |
| Mailing Telephone | 2488587766 |
| Mailing Fax Number | 2488587258 |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2017-08-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 38-1358388 | 05 |
| Street Address |
114 ORCHARD LAKE RD |
| City | PONTIAC |
| State | MI |
| Zip Code | 48341-2244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609892405 | Gary Michael Swarga | Social Worker | 114 Orchard Lake Rd, Pontiac, MI 48341-2244 | 2006-07-14 |
| 1992323281 | Jack Rodriguez | Counselor | 114 Orchard Lake Rd, Pontiac, MI 48341-2244 | 2020-07-13 |
| 1316400914 | Colette Kaitlyn Colzim | Social Worker | 114 Orchard Lake Rd, Pontiac, MI 48341-2244 | 2019-04-10 |
| 1225508450 | Ashley Kristine Polinski | Counselor | 114 Orchard Lake Rd, Pontiac, MI 48341-2244 | 2018-11-30 |
| 1902387871 | Lyndsey Kondor | Social Worker | 114 Orchard Lake Rd, Pontiac, MI 48341-2244 | 2018-08-28 |
| 1588150767 | Danielle Klank | Social Worker | 114 Orchard Lake Rd, Pontiac, MI 48341-2244 | 2018-07-10 |
| 1346733128 | Zoe Maura Compton | Social Worker | 114 Orchard Lake Rd, Pontiac, MI 48341-2244 | 2018-06-07 |
| 1114430675 | Melanie Ann Watson | Case Manager/Care Coordinator | 114 Orchard Lake Rd, Pontiac, MI 48341-2244 | 2017-11-07 |
| 1851827448 | Rachel Ellen Young | Social Worker | 114 Orchard Lake Rd, Pontiac, MI 48341-2244 | 2017-05-03 |
| 1699216630 | Kristen Albright | Counselor | 114 Orchard Lake Rd, Pontiac, MI 48341-2244 | 2017-03-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415837 | Brittany Taylor Shandor | Registered Nurse | 32 East, 1200 Telegraph Rd, Pontiac, MI 48341 | 2020-10-22 |
| 1013534999 | Siddharth Chopra | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue Saint Joseph Mercy Oakland Hospit, Medical Education H-23, Pontiac, MI 48341 | 2020-06-26 |
| 1972120962 | Tara Elizabeth Bjorklund | Obstetrics & Gynecology | 44405 Woodward Ave - H23, St. Joseph Mercy Oakland - Gme Office, Pontiac, MI 48341 | 2020-06-25 |
| 1245856145 | Sarah Fatima | Student in an Organized Health Care Education/Training Program | St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-17 |
| 1407471188 | Tyler Schaefer | Emergency Medical Technician, Basic | 32east 1200 N. Telegraph Rd., Pontiac, MI 48341 | 2020-06-09 |
| 1639793581 | Yash Kirankumar Varma | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-05 |
| 1326661687 | Fnu Kavita | Student in an Organized Health Care Education/Training Program | C/o Shelly Casey, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue Medical Education - H23, Pontiac, MI 48341 | 2020-05-21 |
| 1801452578 | Lolita Curry | Registered Nurse | 32 East 1200 Telegraph, Pontiac, MI 48341 | 2019-05-17 |
| 1619530060 | Priyadarshini Dixit | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, St. Joseph Mercy Oakland Hospita, Pontiac, MI 48341 | 2019-04-20 |
| 1891358370 | Anil Gurpersaud | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave., St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2019-04-19 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013534999 | Siddharth Chopra | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue Saint Joseph Mercy Oakland Hospit, Medical Education H-23, Pontiac, MI 48341 | 2020-06-26 |
| 1245856145 | Sarah Fatima | Student in an Organized Health Care Education/Training Program | St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-17 |
| 1639793581 | Yash Kirankumar Varma | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-05 |
| 1326661687 | Fnu Kavita | Student in an Organized Health Care Education/Training Program | C/o Shelly Casey, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue Medical Education - H23, Pontiac, MI 48341 | 2020-05-21 |
| 1245850064 | Alexandra Lenox | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave Dept H-90, Pontiac, MI 48341-5023 | 2020-04-22 |
| 1568081800 | Jean-yves Reshad Nazroo | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave, Medical Education H-23, Pontiac, MI 48341-2985 | 2020-04-15 |
| 1619530060 | Priyadarshini Dixit | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, St. Joseph Mercy Oakland Hospita, Pontiac, MI 48341 | 2019-04-20 |
| 1891358370 | Anil Gurpersaud | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave., St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2019-04-19 |
| 1831682269 | Swathi Muthyam Mogulla | Student in an Organized Health Care Education/Training Program | St Joseph Mercy Oakland, 44405 Woodward Avenue, Pontiac, MI 48361 | 2018-06-11 |
| 1518496942 | Boris Tkach | Student in an Organized Health Care Education/Training Program | 50 N. Perry, Pontiac, MI 48342 | 2017-06-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.