John C Ottenbacher, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1128 Issued in SD

Practice address

8001 West 5TH Street
Bowdle, SD 57428

Phone

(605) 285-9832

Fax

(605) 285-6986

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/95143858-4077-4cf1-b5d2-c2a999f62bb3/

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.

• Bowdle Hospital

  • Critical Access Hospital
  • Bowdle, SD
  • NPI 1669418877

  SD

  Medicare reassignment NPD
• Bowdle Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Bowdle, SD
  • NPI 1003999152
  NPD
• Mobridge Regional Hospital

  • Rural Health Clinic/Center
  • Selby, SD
  • NPI 1093335333
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1891865705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "city": "SELBY",
            "state": "SD",
            "postal_code": "574720157",
            "telephone_number": "605-649-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 WEST 5TH STREET",
            "city": "BOWDLE",
            "state": "SD",
            "postal_code": "57428",
            "telephone_number": "605-285-9832",
            "fax_number": "605-285-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTENBACHER",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "1128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9174905",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5604543",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS OF SD",
            "identifier": "7684",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bowdle School 22-1
• Lori J Eisenbeisz, D.C.
• JT Anesthesia Prof LLC
• Lacey Kessler, MD
• Amanda Kramer, P.A.
• Travis H Preszler, PA-C
• Turner Drug Inc
• Turner Drug Inc

• All providers in Bowdle, SD
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.