JESSICA L OTT (NPI# 1730661687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730661687 |
| Entity Type | Individual |
| Full Name | JESSICA L OTT |
| Credential | CPNP-PC |
| Practice Address |
23351 Ford Rd Dearborn MI 48128-1258 |
| Mailing Address |
4918 Southpointe Pkwy Monroe MI 48161-4522 |
| Practice Telephone | 3132743123 |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2018-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
4704272956 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801224357 | Jessica Lea Ott | Physical Therapy Assistant | 1067 S Hover St Ste E, Pmb 187, Longmont, CO 80501-7903 | 2013-10-21 |
| 1164876421 | Jessica Ott | Counselor | 2358 Maritime Dr Ste 110, Elk Grove, CA 95758-3662 | 2016-04-22 |
| 1780948778 | Jessica Ann Ott | Student in an Organized Health Care Education/Training Program | 502 E Monroe St, Rapid City, SD 57701-1400 | 2012-06-25 |
| Street Address |
23351 FORD RD |
| City | DEARBORN |
| State | MI |
| Zip Code | 48128-1258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841240538 | Haissam Ghabel El-takech | Pediatrics | 23351 Ford Rd, Dearborn, MI 48128-1258 | 2006-05-11 |
| 1093005613 | Kid Kare Pediatrics, PC | Pediatrics | 23351 Ford Rd, Dearborn, MI 48128-1258 | 2011-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467942219 | Mahmoud Farhat | Dentist | 18590 Outer Dr, Dearborn, MI 48128 | 2018-05-17 |
| 1730607474 | Gentle Hands Direct Care Services, Inc. | Chore Provider | 6659 Schaefer Hwy, Ste. 103, Dearborn, MI 48128 | 2017-09-01 |
| 1396095824 | Corey S. Farber, Pllc | Dentist | 23919 Ford Road, Dearborn, MI 48128 | 2012-09-12 |
| 1184987075 | Yasser Alali | Dentist | 430 North Telegraph Road, Dearborn, MI 48128 | 2012-06-17 |
| 1841573425 | Apple Transportation LLC | Non-emergency Medical Transport (VAN) | 2000 Lafayette, Dearborn, MI 48128 | 2011-09-21 |
| 1407150295 | Dustin Marsh | Psychologist | 19044 Outer Dr, Dearborn, MI 48128 | 2011-01-07 |
| 1619205028 | Michigan-greenfield Urgent Care Pllc | Clinic/Center | 24355 Ford Rd, Dearborn, MI 48128 | 2009-11-23 |
| 1295905065 | Julius Frank Chikos | Dentist | 21775 Wildwood Street, Dearborn, MI 48128 | 2008-03-07 |
| 1003974155 | Walter Knysz Jr. | Dentist | 23401 Ford Road, Dearborn, MI 48128 | 2006-12-04 |
| 1902983703 | Fadi Ahmad Sobh | Pharmacist | 1745 N Silvery Ln, Dearborn, MI 48128 | 2006-11-01 |
| Find all providers in zip 48128 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285120634 | Alexandra Danko | Nurse Practitioner | 5500 Auto Club Dr Ste 160, Dearborn, MI 48126-2779 | 2018-07-09 |
| 1043826092 | Kristina Rose Mason | Nurse Practitioner | 18501 Rotunda Dr, Dearborn, MI 48124-3891 | 2020-09-16 |
| 1982239158 | Alexa Christine Bidigare | Nurse Practitioner | 5901 Chase Rd Ste 110, Dearborn, MI 48126-0900 | 2020-03-09 |
| 1215570957 | Ronia Berry | Nurse Practitioner | 6401 Miller Rd, Dearborn, MI 48126-2363 | 2019-10-25 |
| 1588013973 | Brooke Wanshon | Nurse Practitioner | 2331 Monroe St, Dearborn, MI 48124-3009 | 2016-06-07 |
| 1508138033 | Leslie Marie Mofrad | Nurse Practitioner | 2331 Monroe St, Dearborn, MI 48124-3009 | 2012-01-30 |
| 1790079986 | Kerri Ahern Bernard | Nurse Practitioner | 2845 Monroe St, Dearborn, MI 48124-3491 | 2011-06-05 |
| 1548593353 | Stephanie Lynn Pritula | Nurse Practitioner | 18501 Rotunda Dr, Suite 200, Dearborn, MI 48124-3891 | 2009-09-10 |
| 1083858757 | Tiffany Anna Harris | Nurse Practitioner | 2845 Monroe St, Dearborn, MI 48124-3491 | 2009-04-26 |
| 1285814574 | Linda Corrine Chicko | Nurse Practitioner | 2331 Monroe St, Dearborn, MI 48124-3009 | 2007-11-05 |
| Find all providers in DEARBORN | ||||
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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.