Active NPI
Jennifer Rachel Otis, LMSW
- Social Worker
- Wichita, KS
National Provider Identifier
1689227654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 9965
- Practice address
- 6611 E Central Ave Ste C
Wichita, KS 67206-1937 - Phone
- (316) 689-1353
- NPI assigned
- Jul 18, 2019
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 9965 | KS | Primary |
Addresses
Primary practice location
6611 E Central Ave Ste C
Wichita, KS 67206-1937
Mailing address
2138 S White Oak Cir
Wichita, KS 67207-5253
Phone (316) 689-1353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9965 | KS | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563408000000",
"number": "1689227654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2138 S WHITE OAK CIR",
"city": "WICHITA",
"state": "KS",
"postal_code": "672075253",
"telephone_number": "316-689-1353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6611 E CENTRAL AVE STE C",
"city": "WICHITA",
"state": "KS",
"postal_code": "672061937",
"telephone_number": "316-689-1353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTIS",
"first_name": "JENNIFER",
"middle_name": "RACHEL",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-18",
"last_updated": "2019-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KS",
"license": "9965",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.