JENNIFER LYNN OTWAY (NP) – Nurse Practitioner, NPI 1053127902

JENNIFER LYNN OTWAY (NP) is a healthcare provider. based in Gainesville, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 1180755 (TX). The NPI Number for JENNIFER LYNN OTWAY (NP) is 1053127902

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER LYNN OTWAY (NP)
NPI
1053127902
Phone
Not provided
Address
400 S CULBERSON ST APT 8308
Enumeration Date
5 December 2024
Last Update Date
2 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2145921854
Graduation Year
2024 (2 years ago)
PAC ID
8820525611
Group Practice PAC ID
0547595852
Professional Enrollment ID
I20241218000042
Address ID
TX75006XXXXCAXXXXXXXXXX00
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for JENNIFER LYNN OTWAY (NP)

  • 400 S CULBERSON ST APT 8308

    GAINESVILLE, TX 762403860

    Phone:

    Type: Mailing

  • 3415 NORTH HERITAGE PARKWAY

    SHERMAN, TX 75092

    Phone: (903) 308-4336

    Fax: (903) 771-4541

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241218000042INurse PractitionerTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76240)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547595852View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What identifier follows JENNIFER LYNN OTWAY (NP) across health systems?
The NPI 1053127902 uniquely identifies JENNIFER LYNN OTWAY (NP) in U.S. healthcare data.
Does the public listing show JENNIFER LYNN OTWAY (NP) as active?
JENNIFER LYNN OTWAY (NP)'s NPI record reflects an active status in NPPES.
How should patients interpret JENNIFER LYNN OTWAY (NP)'s specialty?
The extract shows Nurse Practitioner for JENNIFER LYNN OTWAY (NP). Clinical services aligned with this taxonomy classification.
Is JENNIFER LYNN OTWAY (NP) tied to Gainesville, Texas?
If you are local to Gainesville, Texas, JENNIFER LYNN OTWAY (NP) may be relevant to your search.
Who maintains JENNIFER LYNN OTWAY (NP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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