Active NPI
Megan Otto
- Family Nurse Practitioner
- Forest, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 901717
- Practice address
- 330 N Broad St
Forest, MS 39074-3508 - Phone
- (601) 469-4151
- Fax
- (601) 469-3681
- NPI assigned
- Sep 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 901717 | MS | Primary |
Addresses
Primary practice location
330 N Broad St
Forest, MS 39074-3508
Mailing address
330 N Broad St
Forest, MS 39074-3508
Phone (601) 469-4151
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05531862 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
347 S 4TH St
Morton, MS 39117-3407
Phone (601) 732-1524
Hospital & facility affiliations
- Accentcare Home Health of Carthage
- Mississippi Homecare of Jackson
- S E Lackey Memorial Hospital
- Ochsner Scott Regional
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 901717 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Independent Healthcare Management, Inc. | Current | Accepting new patients | |
| Independent Healthcare Management, Inc. | Current | Accepting new patients | |
| Independent Healthcare Management, Inc. | Current | Accepting new patients | |
| Fast Pace Mississippi, PLLC | Family | Current | Accepting new patients |
| Fast Pace Mississippi, PLLC | Current | Accepting new patients |
Locations
330 N Broad St
#S
Forest, MS 39074
Phone (601) 469-4151
330 N Broad St
Forest, MS 39074
Phone (601) 469-4151
110 Pioneer Way
Magee, MS 39111
301 8th Ave SW
Ste B
Magee, MS 39111
376 Simpson Highway 149
Ste 300
Magee, MS 39111
Phone (601) 721-8985
347 S Fourth St
Morton, MS 39117
Phone (601) 732-1524
1017 W Beacon St
Philadelphia, MS 39350
Phone (769) 200-0730
517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206
Interoperability endpoints
- megan.otto@phspch.eclinicaldirectplus.com
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.
-
- Critical Access Hospital
- Forest, MS
- NPI 1306909734
-
- Rural Health Clinic/Center
- Kosciusko, MS
- NPI 1851050579
-
- Rural Health Clinic/Center
- Raleigh, MS
- NPI 1871272724
-
- Rural Health Clinic/Center
- Morton, MS
- NPI 1952694994
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Forest, MS
- NPI 1306909734
-
- Home Health Agency
- Jackson, MS
- NPI 1730373275
-
- Critical Access Hospital
- Morton, MS
- NPI 1134278435
-
- Home Health Agency
- Carthage, MS
- NPI 1275674533
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538352000000",
"number": "1609323450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 N BROAD ST",
"city": "FOREST",
"state": "MS",
"postal_code": "390743508",
"telephone_number": "601-469-4151",
"fax_number": "601-469-3681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 N BROAD ST",
"city": "FOREST",
"state": "MS",
"postal_code": "390743508",
"telephone_number": "601-469-4151",
"fax_number": "601-469-3681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTO",
"first_name": "MEGAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-08",
"last_updated": "2018-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "901717",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05531862",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Forest, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.