Jennifer L Otterbein, RN, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

248715 Issued in AZ

Practice address

13400 E Shea Blvd
Scottsdale, AZ 85259-5452

Phone

(480) 301-8000

NPI assigned

Feb 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jennifer L Cooper Former name

Medicare fee-for-service enrollment

Enrolled in MN, AZ2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Promed Preferred MN PLLCGroup PAC ID 3870008980, 8 clinicians

Athena Medical GroupGroup PAC ID 8921358706, 43 clinicians

Integrated Wound Care Minnesota PLLCGroup PAC ID 2769722511, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpurdy139630@ehrdirect.mayoclinicmsg.org

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.

• Integrated Wound Care Minnesota PLLC

  • General Practice Physician
  • Delano, MN
  • NPI 1205390457
  Medicare reassignment Care Compare group NPD
• Athena Medical Group

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1164918124
  Medicare reassignment Care Compare group
• Promed Preferred MN PLLC

  • Internal Medicine Physician
  • Owatonna, MN
  • NPI 1841057817
  Medicare reassignment Care Compare group
• Verdure Health Services

  • Family Medicine Physician
  • Irving, TX
  • NPI 1801495940
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1467425751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERBEIN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "RN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "2375",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "CNP2375",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "248715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "COOPER",
            "middle_name": "L",
            "credential": "RN, CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nurse Practitioner in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.