MR. GERALD MICHAEL OTTENWALDER (NPI# 1417449083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417449083 |
| Entity Type | Individual |
| Full Name | MR. GERALD MICHAEL OTTENWALDER |
| Credential | KCPM |
| Practice Address |
420 Kennedy St Burlington KS 66839-1120 |
| Mailing Address |
625 Sherman St Emporia KS 66801-2401 |
| Practice Telephone | 6203642606 |
| Mailing Telephone | 6207572661 |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2018-05-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | KS | Other Service Providers |
| Street Address |
420 KENNEDY ST |
| City | BURLINGTON |
| State | KS |
| Zip Code | 66839-1120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699741264 | Gayle M Taylor-ford | Counselor | 420 Kennedy St, Burlington, KS 66839-1120 | 2006-02-24 |
| 1104342427 | Ceara Shaughnessy | Counselor | 420 Kennedy St, Burlington, KS 66839-1120 | 2017-08-17 |
| 1528447620 | Sandra J Marlatte | Counselor | 420 Kennedy St, Burlington, KS 66839-1120 | 2015-05-21 |
| 1790184927 | Debra Ann Reaves | Counselor | 420 Kennedy St, Burlington, KS 66839-1120 | 2014-08-13 |
| 1245652015 | Kathy Elizabeth Peterson | Counselor | 420 Kennedy St, Burlington, KS 66839-1120 | 2014-01-14 |
| 1679914923 | Johnny L Edwards | Social Worker | 420 Kennedy St, Burlington, KS 66839-1120 | 2013-07-16 |
| 1871839928 | Bradley Kessell | Counselor | 420 Kennedy St, Burlington, KS 66839-1120 | 2012-12-18 |
| 1841536059 | Beth Ellen Dayton | Counselor | 420 Kennedy St, Burlington, KS 66839-1120 | 2012-12-14 |
| 1083959449 | Christine D Currier | Counselor | 420 Kennedy St, Burlington, KS 66839-1120 | 2012-12-11 |
| 1740447168 | Timothy Jay Donahue | Counselor | 420 Kennedy St, Burlington, KS 66839-1120 | 2008-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093136046 | Roland Paranal Sinfuego | Physical Therapist | 601 Cross St., Burlington City, KS 66839 | 2013-12-18 |
| 1407061567 | Megan Rae Bush | Physical Therapist | North 4th Street, Coffey County Hosptial Rehab Services, Burlington, KS 66839 | 2007-05-11 |
| 1093844961 | Thomas Duayne Kesler | Physical Therapy Assistant | 601 Cross Street, Burlington, KS 66839 | 2007-03-05 |
| 1366546368 | R Wayne Kirchner | Chiropractor | 910 North 4th, Burlington, KS 66839 | 2006-09-11 |
| 1669460614 | James H Mcmurray | Dentist | 209 N Main St, New Strawn, KS 66839-0535 | 2005-10-12 |
| 1790817476 | Rachel Michelle Blades Belcher | Occupational Therapist | 505 South 16th Street, Burlington, KS 66839-1105 | 2007-03-09 |
| 1649227398 | Burlington Medical Investors, LLC | Skilled Nursing Facility | 601 Cross St, Burlington, KS 66839-1105 | 2006-05-28 |
| 1639525918 | Laurie Ohl | Occupational Therapy Assistant | 601 Cross St, Burlington, KS 66839-1105 | 2016-05-05 |
| 1528413697 | Heather Bolen | Physical Therapist | 601 Cross St, Burlington, KS 66839-1105 | 2016-04-26 |
| 1447649132 | Rose Winkler | Physical Therapy Assistant | 601 Cross St, Burlington, KS 66839-1105 | 2015-01-18 |
| Find all providers in zip 66839 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952915159 | Precious Ebony Davis | Peer Specialist | 1119 Richmond Ave, Kansas City, KS 66104-5945 | 2020-09-04 |
| 1952852147 | Kyle Spencer | Peer Specialist | 2017 S Chautauqua Ave, Wichita, KS 67211-5615 | 2016-10-22 |
| 1821610643 | Callow Binah Louise Phoenix | Peer Specialist | 4015 Sw 21st St, Topeka, KS 66604-3412 | 2020-05-14 |
| 1962034017 | Ryan Funk | Peer Specialist | 2500 W 31st St Ste G, Lawrence, KS 66047-3051 | 2020-02-06 |
| City | BURLINGTON |
| Zip Code | 66839 |
Please comment or provide details below to improve the information on MR. GERALD MICHAEL OTTENWALDER.
| 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.