Peggy Otterstetter, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704131878 Issued in MI

Practice address

1255 N Oakland Blvd
Waterford, MI 48327-1545

Phone

(248) 406-0900

Fax

(248) 406-0098

NPI assigned

Dec 2, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Programs, Inc.

  • Substance Abuse Rehabilitation Facility
  • Waterford, MI
  • NPI 1578014940
  Medicare reassignment

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

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1124561584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 N OAKLAND BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271545",
            "telephone_number": "248-406-0900",
            "fax_number": "248-406-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 N OAKLAND BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271545",
            "telephone_number": "248-406-0900",
            "fax_number": "248-406-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERSTETTER",
        "first_name": "PEGGY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-02",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704131878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Michael Orvis, DC
• Robert Oshnock, PA-C
• Dawn Osman Fraser
• Diana Kamal Osman, PTA
• Emily Otten
• Jeanette Elaine Owens, MA, LLPC
• Rodolfo Anthony Pacheco, LLMSW
• John Padura, PT
• Grace Marie Pagaduan-Oddo, D.O.
• Lisa Ann Page

• Family Nurse Practitioner in Waterford, MI
• Providers in Waterford, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.