Deron Ck Ottey (NPI# 1871550780, PAC ID# 4688620024) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1871550780 |
| PAC ID by PECOS | 4688620024 |
| Professional Enrollment ID | I20120426000231 |
| Full Name | Deron Ck Ottey |
| Address |
417 W Call St Starke FL 32091-3115 |
| Gender | M |
| Credential | MD |
| Medical School | MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE |
| Graduation Year | 1997 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100321 | ST VINCENTS MEDICAL CENTER - CLAY COUNTY |
| 100156 | LAKE CITY MEDICAL CENTER |
| 101310 | SHANDS STARKE REGIONAL MEDICAL CENTER |
| 100102 | SHANDS LAKE SHORE REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 417 W Call St, Starke, FL 32091-3115 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Street Address |
417 W CALL ST |
| City | STARKE |
| State | FL |
| Zip | 32091-3115 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Judith E Lynch | Physician Assistant | Trenton Medical Center, Inc | 550 W Georgia St, Starke, FL 32091-1816 |
| Tiffany N Rogers | Nurse Practitioner | Trenton Medical Center, Inc | 550 W Georgia St, Starke, FL 32091-1816 |
| Andrew Owen | Physician Assistant | Trenton Medical Center, Inc | 550 W Georgia St, Starke, FL 32091-1816 |
| Lynne M Webster | Nurse Practitioner | Florida Department of Health | 1801 N Temple Ave, Starke, FL 32091-1960 |
| Virgil A Berry Jr. | Chiropractic | 601 E Call St, Starke, FL 32091-3405 | |
| Andrea E Waterhouse | Nurse Practitioner | Bradford Emergency Group LLC | 922 E Call St, Starke, FL 32091-3616 |
| Samer O Salhab | Diagnostic Radiology | Fands Radiology PC | 922 E Call St, Starke, FL 32091-3616 |
| Olutayo T Olabige | Nephrology | 922 E Call St, Starke, FL 32091-3616 | |
| James M Switzer | Diagnostic Radiology | Fands Radiology PC | 922 E Call St, Starke, FL 32091-3616 |
| Wylene N Bhanji | Emergency Medicine | Bradford Emergency Group LLC | 922 E Call St, Starke, FL 32091-3616 |
| Find all physicians in zip 32091 | |||
| City | STARKE |
| Zip Code | 32091 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | STARKE + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Deron Ck Ottey.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.