Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Janae L Otto

Individual provider Family Nurse Practitioner · NPI 1407749179

Janae L Otto is a Nurse Practitioner in Columbus, Ohio. Qualified in 2024, 2 years ago. Practices with Licking Memorial Professional Corporation, a 235-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
2
Licensed in
OH
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

520 W 10th Ave
Columbus, OH 43210-1328
Phone: (614) 293-8305
Fax: (614) 685-7108
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1320 W Main St, Newark, OH 43055-1822 — (220) 564-4144

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN.CNP.0039093 (OH)
Nurse Practitioner Taxonomy 363L00000X · Licence APRN.CNP.0039093 (OH)

Record details

NPI number1407749179
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 2, 2025
Last updated in NPPESJuly 1, 2026
Certification dateJuly 1, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Licking Memorial Professional Corporation — 235 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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