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Bryan David Otley, PA-C

NPI 1508671066ActiveIndividual· Physician Assistant· Jackson, MS

Physician Assistant (PA-C) with Mississippi Sports Medicine and Orthopaedic Center, practicing in Jackson, Mississippi. Enrolled in Medicare as practitioner - physician assistant.

Overview

NPI1508671066
StatusActive
Entity typeIndividual
CredentialPA-C
Sole proprietorNo
NPI issuedFeb 11, 2025
Last updated in NPPESMar 9, 2026
Certified by providerMar 9, 2026

Specialties and licenses

TaxonomyCodeLicenseState
Physician Assistant Primary363A00000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Physician Assistant (MS)

Medicare sources and data years

Education and affiliations

Graduation year2025
Medicare specialtyPhysician Assistant

Medical group

Source: CMS Care Compare

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Physician Assistant providers in Jackson

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