Jennifer Renee Otterbach, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11033150 Issued in FL

Practice address

2349 Village Square Pkwy Ste 107
Fleming Island, FL 32003-4319

Phone

(904) 223-3321

Fax

(904) 223-2169

NPI assigned

Oct 8, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacksonville Spine Center PAGroup PAC ID 6901890300, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.otterbach@jspc.eclinicaldirectplus.com
• Direct secure messaging: jotterbach465404@direct.shands.ufl.edu

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.

• Jacksonville Spine Center PA

  • Pain Medicine (Anesthesiology) Physician
  • Jacksonville, FL
  • NPI 1881643757

  FL

  Medicare reassignment Care Compare group NPD
• Jacksonville Spine Center PA

  • Interventional Pain Medicine Physician
  • Altamonte Springs, FL
  • NPI 1861197071
  NPD
• Georgia Spine & Pain Centers

  • Interventional Pain Medicine Physician
  • Waycross, GA
  • NPI 1134769714
  NPD (past)

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

• Flagler Hospital Inc

  • General Acute Care Hospital
  • St Augustine, FL
  • NPI 1144211020

  Hospital

  Care Compare affiliation
• Flagler Hospital, Inc.

  • Urgent Care Clinic/Center
  • Saint Augustine, FL
  • NPI 1447527965

  Hospital

  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1871845313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY FL 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 VILLAGE SQUARE PKWY STE 107",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034319",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14534 Old Saint Augustine Rd Ste 3210",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322582645",
            "country_code": "US",
            "telephone_number": "904-880-1260",
            "fax_number": "904-880-1210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTERBACH",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11033150",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11033150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.