Phillip Martin Otterness

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Practice address

3152 23Rd Ave S Apt 2
Minneapolis, MN 55407-5573

Phone

(612) 321-8008

NPI assigned

Oct 26, 2023

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Welcome Home Housing Stabilization LLC

  • Case Management Agency
  • Minneapolis, MN
  • NPI 1104667534
  NPD Authorized official

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1154193639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152 23RD AVE S APT 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554075573",
            "telephone_number": "612-321-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152 23RD AVE S APT 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554075573",
            "telephone_number": "612-321-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERNESS",
        "first_name": "PHILLIP",
        "middle_name": "MARTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-26",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick W Ott, MD
• Nancy Lorene Ott, MD
• Alice M. Ottavi, DDS
• Derek Steven Otte, MSW, LICSW
• Lindsay Otte, AGACNP-BC
• Sara Ann Otterness, APRN-BC
• Emily Kate Otteson, BAN, RN, PHN
• Julie Ann Otto, CRNA
• Kathryn Otto, DO
• Sara Kristin Otto

• Case Management Agency in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Case Management Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.