| Dr Justin A Otis, DNP, APRN-CRNA | |
|
11723 Wells Creek Pkwy Apt 1217, Jacksonville, FL 32256-1981 | |
| (904) 240-2841 | |
| Not Available |
| Full Name | Dr Justin A Otis |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 2 Years |
| Location | 11723 Wells Creek Pkwy Apt 1217, Jacksonville, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245911262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | RN9356204 (Florida) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 4012118 (Kentucky) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Baptist Health Lagrange | La grange, KY | Hospital |
| King's Daughters' Health | Madison, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Greater Louisville Anesthesia Services, Pllc | 2264410661 | 10 |
| Community Medical Associates Inc | 7012811284 | 1310 |
| Entity Name | Greater Louisville Anesthesia Services, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326126681 PECOS PAC ID: 2264410661 Enrollment ID: O20040712001150 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Justin A Otis, DNP, APRN-CRNA 2115 Judge Carden Blvd, Crestwood, KY 40014-7805 Ph: (904) 240-2841 | Dr Justin A Otis, DNP, APRN-CRNA 11723 Wells Creek Pkwy Apt 1217, Jacksonville, FL 32256-1981 Ph: (904) 240-2841 |
Crystal Lynn, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 | |
Lauren E Freed, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 | |
Dr. Sarah Anne Piscitello, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Shircliff Way, Jacksonville, FL 32204 Phone: 904-477-5855 | |
Lindsay Michelle Putkowski, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3625 University Blvd S, Jacksonville, FL 32216 Phone: 904-702-6111 | |
Michelle Alicia Coy, DNP Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2080 Child St Dept 5000, Jacksonville, FL 32214 Phone: 904-542-7300 | |
Kristina Schneider, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 | |
Mr. Bruce Anthony Wilburn, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2165 Herschel St, Jacksonville, FL 32204 Phone: 904-387-1220 |