Individual provider Active NPI

Alicia Holly Ottenweller, FNP-C

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1164942538
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71007384A Issued in IN
Practice address
426 S Alabama St Ste 100
Indianapolis, IN 46225-3301
Phone
(317) 528-2489
Fax
(317) 528-3770
NPI assigned
Jun 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28226461A IN
Family Nurse Practitioner 363LF0000X 71007384A IN Primary

Addresses

Primary practice location

426 S Alabama St Ste 100
Indianapolis, IN 46225-3301

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other names 1

  • Alicia Adam Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aottenweller510082@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20170926000062 IN Practitioner - Nurse Practitioner 2264706522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

426 S Alabama St
Suite 100
Indianapolis, IN 46225-3301
Phone (317) 528-2489

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28226461AINMDFamily Nurse Practitioner
71007384AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Apr 30, 2020 Accepting new patients
Raphael Health Center, Inc CurrentSince Sep 6, 2017 Accepting new patients
Raphael Health Center, Inc CurrentSince Sep 6, 2017 Accepting new patients
Franciscan Physician Network CurrentSince Apr 30, 2020 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1040 Sierra Dr
Greenwood, IN 46143
Phone (317) 528-2759

401 E 34th St
Indianapolis, IN 46205
Phone (317) 926-1507

426 S Alabama St
Ste 100
Indianapolis, IN 46225
Phone (317) 528-2486

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDCGDD

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1164942538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 S ALABAMA ST STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462253301",
            "telephone_number": "317-528-2489",
            "fax_number": "317-528-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTENWELLER",
        "first_name": "ALICIA",
        "middle_name": "HOLLY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28226461A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007384A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aottenweller510082@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "426 S Alabama St Ste 100",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462253301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "ADAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.