STEPHANIE OTTIMO (NPI# 1033635925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033635925 |
Entity Type | Individual |
Full Name | STEPHANIE OTTIMO |
Credential | NP |
Practice Address |
5730 Glenridge Dr Ste 200 Atlanta GA 30328 |
Mailing Address |
3495 Piedmont Rd Ne Bldg 9 1st Floor Atlanta GA 30305-1736 |
Practice Telephone | 4042525206 |
Mailing Telephone | 4043650966 |
Enumeration Date | 2017-08-22 |
Last Update Date | 2019-04-15 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN235965 | GA | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
RN235965 | GA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | RN LICENSE | RN235965 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
3367 Buford Hwy Ne Ste 910, Brookhaven, GA 303291833 | 4043214692 |
Street Address |
5730 GLENRIDGE DR STE 200 |
City | ATLANTA |
State | GA |
Zip Code | 30328 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710089404 | Mark A Haber | Urology | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2006-09-02 |
1679137467 | Shannon Suarez | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2019-04-26 |
1336623222 | Beniam Tefera Abebe | Physician Assistant | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2018-09-18 |
1194230961 | Carrie Collin | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328 | 2017-12-02 |
1770093213 | Callie Denmark Duggan | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2017-10-11 |
1851821805 | Kristin L Wellman | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2017-06-13 |
1578925129 | Jennifer Garner | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2016-03-23 |
1003244013 | Andrea Mitchell Center | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2013-10-30 |
1740520543 | Karmon Janssen | Urology | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2013-02-15 |
1215283775 | Shenelle Wilson | Urology | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2012-08-01 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467910042 | Amber Andrews | Behavior Technician | 750 Hammond Drive Bldg 7 Suite 100, Atlanta, GA 30328 | 2019-03-04 |
1215492830 | Ryan William Dubinin | Behavior Technician | 750 Hammond Drive, Building 7, Suite 100, Atlanta, NJ 30328 | 2019-02-07 |
1346710142 | Emily Rose Lloyd Swavely | Speech-Language Pathologist | 5825 Glenridge Rd., Building 1, Suite 133, Atlanta, GA 30328 | 2018-12-05 |
1063994481 | Mark Edward Brachmanski | Optometrist | 800 Mount Vernon Highway Ne, Suite 130, Atlanta, GA 30328 | 2018-09-01 |
1407352578 | Nina Brown | Massage Therapist | 7100 Peachtree Dunwoody Rd Ste 110, Sandy Springs, GA 30328 | 2018-04-05 |
1336657741 | Renee Usher Reeves | Assistant Behavior Analyst | 750 Hammond Dr Building 7, Suite 100, Atlanta, GA 30328 | 2018-01-19 |
1487168274 | Patricia Nicole Felder | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr, Ne, Suite # 400, Atlanta, GA 30328 | 2017-12-01 |
1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
1770093601 | Syed M Rasheed | Physician Assistant | 5788 Roswell Rd Ste 100, Atlanta, GA 30328 | 2017-10-05 |
1437678190 | Jeanette Denise Jones | Counselor | 270 Carpenter Drive, Suite 400, Sandy Springs, GA 30328 | 2017-09-13 |
Find all providers in zip 30328 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
1790398790 | Starr Patrice Dickerson | Nurse Practitioner | 655 Dot Dr, Atlanta, GA 30349-2730 | 2020-08-28 |
1265042162 | Habida Elachola | Nurse Practitioner | 2533 Henderson Mill Rd Ne, Atlanta, GA 30345-2135 | 2020-08-05 |
1184249815 | Nichelle Osborne | Nurse Practitioner | 5785 Roswell Rd, Atlanta, GA 30328-4903 | 2020-06-09 |
1902427149 | Oasis Health Services, LLC | Nurse Practitioner | 6595 Roswell Rd Ste G1255, Atlanta, GA 30328-3152 | 2020-04-28 |
1063042927 | Mary Gillon Hall | Nurse Practitioner | 90 La Rue Pl Nw, Atlanta, GA 30327-4075 | 2020-01-20 |
1396382321 | Stacey Brinkley | Nurse Practitioner | 3725 Princeton Lakes Pkwy Sw Apt 7304, Atlanta, GA 30331-5564 | 2019-12-10 |
1801439401 | Debadrita Mondal | Nurse Practitioner | 180 Jackson St Ne Apt 2506, Atlanta, GA 30312-1373 | 2019-10-26 |
1265075170 | Cecile Veronica Maner | Nurse Practitioner | 105 Collier Rd Nw Ste 3040, Atlanta, GA 30309-1733 | 2019-10-23 |
1194366567 | Tondalaya K Sanford | Nurse Practitioner | 3119 Fonseca Pass, Atlanta, GA 30349-8140 | 2019-10-07 |
Find all providers in ATLANTA |
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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.