MR. GERALD MICHAEL OTTENWALDER KCPM NPI 1417449083

NPI Information

NPI: 1417449083
Provider Name: MR. GERALD MICHAEL OTTENWALDER, KCPM
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
420 KENNEDY ST
BURLINGTON, KS
ZIP 66839
Phone: (620) 364-2606
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MR. Gerald Michael Ottenwalder, KCPM is a peer specialist in Burlington, KS. The provider is 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. MR. Gerald Michael Ottenwalder, KCPM NPI is 1417449083. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

420 KENNEDY ST
BURLINGTON, KS
ZIP 66839-120
Phone: (620) 364-2606

The enumeration date for this NPI number is 5/30/2018 and was last updated on 5/30/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	175T00000X	Peer Specialist			KANSAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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