MRS. ALICE CAMILLE OTTO (NPI# 1841594025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841594025 |
| Entity Type | Individual |
| Full Name | MRS. ALICE CAMILLE OTTO |
| Other Name | MISS ALICE CAMILLE KETCHEM |
| Credential | NP |
| Practice Address |
2605 N Lebanon St Lebanon IN 46052-1476 |
| Mailing Address |
2705 N Lebanon St Ste 305 Lebanon IN 46052-8622 |
| Practice Telephone | 7654858124 |
| Practice Fax Number | 7654858669 |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2020-02-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208M00000X | Hospitalist | 71003805A | IN | Allopathic & Osteopathic Physicians |
| N | 363L00000X | Nurse Practitioner | 71003805A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
71003805A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201042160 | 05 |
| Street Address |
2605 N LEBANON ST |
| City | LEBANON |
| State | IN |
| Zip Code | 46052-1476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700870060 | Doris E Taylor Austin | Anesthesiology | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2005-09-01 |
| 1396222733 | Bailey C Goodman | Physician Assistant | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2018-07-27 |
| 1598253577 | Charles E. Wade | Hospitalist | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2018-04-25 |
| 1780126920 | Lacey N Christian | Hospitalist | 2605 N Lebanon St, Lebanon, IN 46052 | 2016-11-04 |
| 1053867572 | Mary Katherine Fuller-nave | Hospitalist | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2016-08-26 |
| 1598112955 | Christina Seib Stinnette | Anesthesiology | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2016-05-16 |
| 1891175063 | Richele Kelly | Anesthesiology | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2015-06-03 |
| 1104220078 | Nicholas Osborne | Hospitalist | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2014-10-21 |
| 1588071914 | Witham Memorial Hospital | Skilled Nursing Facility | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2014-07-17 |
| 1184057671 | Laura Devlin | Nurse Practitioner | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2013-08-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316567647 | Meredith England Labrie | Behavioral Analyst | 110 Birchwood Drivve, Lebanon, IN 46052 | 2020-04-16 |
| 1710401492 | Kenzlie Ann Westerfield | Specialist/Technologist | 613 Countryside Drive, Lebanon, IN 46052 | 2017-08-03 |
| 1487040044 | Jenny L Essex | Social Worker | 1614 N. Lebanon St., Integrative Wellness, LLC, Lebanon, IN 46052 | 2015-04-10 |
| 1316177363 | Kathryn Elizabeth Ehrgott | Counselor | 1005 South Lebanon Street, Boone County Services, Lebanon, IN 46052 | 2009-07-23 |
| 1780838557 | Kathleen M Whitaker | Registered Nurse | 209 W North St, Lebanon, IN 46052 | 2008-11-06 |
| 1851551998 | James R Mcafee | General Practice | 1997 Terrace Ln, Lebanon, IN 46052 | 2008-06-12 |
| 1518021773 | Zulfiqar Ali Mirza | Internal Medicine | 2505 N Lebanon St Ste 220, Lebanon, IN 46052 | 2006-12-21 |
| 1316016108 | Russell Allen Lindner | Chiropractor | 3920 North State Road 39, Boone County Chiropractic Office, Lebanon, IN 46052 | 2006-11-07 |
| 1487755781 | Cowan Drugs Inc | Pharmacy | 112 N Lebanon St, Lebanon, IN 46052 | 2006-09-26 |
| 1558463992 | Cowan Drugs Inc | Pharmacy | 1639 N Lebanon St, Lebanon, IN 46052 | 2006-09-05 |
| Find all providers in zip 46052 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568437127 | Sergei L Joffy | Hospitalist | 850 Tuck St, Lebanon, PA 17042-7477 | 2006-02-17 |
| 1568937423 | Erica R Light | Hospitalist | 252 S 4th St Fl 3, Lebanon, PA 17042-6111 | 2018-10-08 |
| 1710462411 | Andrea Schremph | Hospitalist | 252 S 4th St Fl 3, Lebanon, PA 17042-6123 | 2018-09-27 |
| 1598253577 | Charles E. Wade | Hospitalist | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2018-04-25 |
| 1720504152 | Elizabeth A Petcov | Hospitalist | 252 S 4th St, Lebanon, PA 17042-6111 | 2017-08-17 |
| 1780126920 | Lacey N Christian | Hospitalist | 2605 N Lebanon St, Lebanon, IN 46052 | 2016-11-04 |
| 1053867572 | Mary Katherine Fuller-nave | Hospitalist | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2016-08-26 |
| 1780137802 | Mascoma Street Inpatient Services LLC | Hospitalist | 10 Alice Peck Day Dr, Lebanon, NH 03766-2900 | 2016-07-25 |
| 1003263823 | Nilofar Najafian | Hospitalist | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2016-05-23 |
| 1710332390 | Sean Xiang Li | Hospitalist | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2016-05-02 |
| Find all providers in LEBANON | ||||
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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.