Individual provider Active NPI

Brandon Michael Otterson, RN

  • Registered Nurse
  • Barrington, IL
National Provider Identifier
1033071691
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041399907 Issued in IL
Practice address
450 W Highway 22
Barrington, IL 60010-1919
Phone
(847) 381-9600
Fax
(847) 842-4166
NPI assigned
Dec 2, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041399907 IL Primary

Addresses

Primary practice location

450 W Highway 22
Barrington, IL 60010-1919

Mailing address

450 W Highway 22
Barrington, IL 60010-1919
Phone (847) 381-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041399907ILMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1033071691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W HIGHWAY 22",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600101919",
            "telephone_number": "847-381-9600",
            "fax_number": "847-842-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W HIGHWAY 22",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600101919",
            "telephone_number": "847-381-9600",
            "fax_number": "847-842-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERSON",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041399907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barrington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.