Jennifer Otterbacher

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34.013646 Issued in OH

Practice address

888 Dayton St Ste 200
Yellow SPGS, OH 45387-1777

Phone

(937) 767-7291

Fax

(937) 767-1302

NPI assigned

Mar 28, 2017

Last updated

Mar 7, 2023By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Homecare Home health agency, Kettering, OH, CCN 367778
• Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Kettering Health Greene Memorial Hospital, Xenia, OH, CCN 360026
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jotterbacher574140@direct.ketteringhealth.org

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

• Alliance Physicians Inc

  dba Kettering Health Medical Group

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  Medicare reassignment Care Compare group NPD
• Alliance Physicians Inc

  dba Kettering Head & Neck Surgery

  • Surgery Physician
  • Kettering, OH
  • NPI 1457781221
  NPD
• Greene Memorial Hospital Inc

  dba Kettering Health Greene Memorial

  • General Acute Care Hospital
  • Xenia, OH
  • NPI 1255317848
  NPD (past)

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

• Alternate Solutions Homecare of Dayton, LLC

  • Home Health Agency
  • Kettering, OH
  • NPI 1639195332
  Care Compare affiliation
• Beavercreek Medical Center

  dba Soin Medical Center

  • General Acute Care Hospital
  • Beavercreek, OH
  • NPI 1760764849
  Care Compare affiliation
• Dayton Osteopathic Hospital

  dba Kettering Health Dayton

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Greene Memorial Hospital Inc

  dba Kettering Health Greene Memorial

  • General Acute Care Hospital
  • Xenia, OH
  • NPI 1255317848
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Main Campus

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1184156358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 DAYTON ST STE 200",
            "city": "YELLOW SPGS",
            "state": "OH",
            "postal_code": "453871777",
            "telephone_number": "937-767-7291",
            "fax_number": "937-767-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 DAYTON ST STE 200",
            "city": "YELLOW SPGS",
            "state": "OH",
            "postal_code": "453871777",
            "telephone_number": "937-767-7291",
            "fax_number": "937-767-1302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-3245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTERBACHER",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2023-03-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.013646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0407603",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jotterbacher574140@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "888 Dayton St Ste 200",
            "city": "Yellow Spgs",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453871777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "888 Dayton St Ste 200",
            "city": "Yellow Spgs",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453871777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.