FRED M OTT (NPI# 1043509631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043509631 |
| Entity Type | Individual |
| Full Name | FRED M OTT |
| Credential | RPH |
| Practice Address |
5425 W Chinden Blvd Garden City ID 83714-1468 |
| Mailing Address |
10789 W Dason Ct Boise ID 83713-1850 |
| Practice Telephone | 2083237036 |
| Mailing Telephone | 2083751486 |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2011-04-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | CS2026 | ID | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | P4096 | ID | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699877183 | Fred D Ott | Dermatology | 14406 Ne 20th Ave, Vancouver, WA 98686-1448 | 2006-09-04 |
| Street Address |
5425 W CHINDEN BLVD |
| City | GARDEN CITY |
| State | ID |
| Zip Code | 83714-1468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316983224 | Fred Meyer Stores Inc | Pharmacy | 5425 W Chinden Blvd, Garden City, ID 83714-1468 | 2006-06-20 |
| 1659712164 | David Sauter | Pharmacist | 5425 W Chinden Blvd, Garden City, ID 83714-1468 | 2013-07-12 |
| 1992094304 | Benjamin Jesse Cook | Pharmacist | 5425 W Chinden Blvd, Garden City, ID 83714-1468 | 2011-04-06 |
| 1780973370 | Francine Lorraine Kimball | Pharmacist | 5425 W Chinden Blvd, Garden City, ID 83714-1468 | 2011-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932683752 | Ikdo State Street LLC | Dentist | 9209 W State St, Garden City, ID 83714 | 2018-09-18 |
| 1437608007 | Carrie Boroughs Breaux | Ophthalmology | 5019 N Sawyer Ave, Garden City, ID 83714 | 2016-09-23 |
| 1841646007 | Alliance Medical Group, LLC | Family Medicine | 5601 W. Chinden Blvd., Garden City, ID 83714 | 2016-05-06 |
| 1134580467 | Rebecca Gillet | Physical Therapist | 6576 W Dufferin Ct, Boise, ID 83714 | 2016-03-15 |
| 1063816007 | Ingri Suzanne Koloski | Counselor | 8969 West Hepburn Lane, Garden City, ID 83714 | 2014-10-20 |
| 1679909329 | Anile Nina | Counselor | 5484 N Gary Lane, Boise, ID 83714 | 2013-09-25 |
| 1215360292 | William Blake Bybee | Dentist | 5833 W. Hidden Springs Dr., Boise, ID 83714 | 2013-08-14 |
| 1871833327 | Charmaine Read | Social Worker | 123 E. 44th St, Ste. A, Garden City, ID 83714 | 2013-02-20 |
| 1811206576 | Bennett Medical Services | Durable Medical Equipment & Medical Supplies | 5220 Sawyer Court, Suite D, Garden City, ID 83714 | 2010-09-29 |
| 1073780680 | Barry Lynn Williams | Pharmacist | 7020 W State Street, Boise, ID 83714 | 2008-05-13 |
| Find all providers in zip 83714 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841817566 | Amee A Shah | Pharmacist | 6255 Inkster Rd Ste 106, Garden City, MI 48135-2538 | 2020-06-29 |
| 1720571813 | Keith Earnest Venjohn | Pharmacist | 3101 East Kansas Ave, Garden City, KS 67846 | 2018-06-13 |
| 1366964579 | Inemesit Akpan | Pharmacist | 501 Franklin Ave Ste 300, Garden City, NY 11530-5807 | 2017-07-10 |
| 1215460449 | Hiam Bazzi | Pharmacist | 819 Inkster Rd, Garden City, MI 48135-4118 | 2017-04-05 |
| 1659812279 | Cynthia Brungardt | Pharmacist | 2424 N. Taylor Avenuee, Garden City, KS 67846 | 2017-03-15 |
| 1548623952 | David Wolnie | Pharmacist | 29600 Ford Rd, Garden City, MI 48135-2365 | 2016-04-02 |
| 1629469440 | Emile Dicairano | Pharmacist | 22 Stratford Ave, Garden City, NY 11530-2346 | 2015-02-16 |
| 1396172979 | Stanley Abraham Saji | Pharmacist | 501 Franklin Ave Ste 140, Garden City, NY 11530-5807 | 2013-09-27 |
| 1245671650 | Fatima Sader | Pharmacist | 29447 Ford Rd, Garden City, MI 48135-2319 | 2013-07-13 |
| 1215285960 | Fatme Rakine | Pharmacist | 29452 Cherry Hill Rd, Garden City, MI 48135-2613 | 2012-08-28 |
| Find all providers in GARDEN CITY | ||||
| City | GARDEN CITY |
| Zip Code | 83714 |
Please comment or provide details below to improve the information on FRED M OTT.
| 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.