Cotton Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038009460 Issued in IL

Legal business name

COTTON CHIROPRACTIC, LLC

Practice address

901 W Glen Ave
Suite a
Peoria, IL 61614-4839

Phone

(309) 693-1212

Fax

(309) 693-2147

NPI assigned

Sep 5, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Brad A Cotton, DCNPI 1942390216

Title

Owner/Chiropractor

Phone

(309) 208-3094

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brad Anthony Cotton, D.C.

  • Chiropractor
  • Peoria, IL
  • NPI 1942390216
  Medicare reassignment NPD Authorized official
• Ryder Michael Church, D.C.

  • Chiropractor
  • Peoria, IL
  • NPI 1104898659
  NPD (past)
• Tracie A Khoury, DC

  • Chiropractor
  • Peoria, IL
  • NPI 1588639835
  NPD (past)

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1013318336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W GLEN AVE",
            "address_2": "SUITE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144839",
            "telephone_number": "309-693-1212",
            "fax_number": "309-693-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W GLEN AVE",
            "address_2": "SUITE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144839",
            "telephone_number": "309-693-1212",
            "fax_number": "309-693-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTON CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "COTTON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "309-208-3094",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Corzatt, PT
• Jillian Marie Costello, DO
• Aaron Costerisan, M.D.
• Kelli M Cothern, SPEECH THERAPIST
• Kyle Cotner, MD
• Brad Anthony Cotton, D.C.
• Laketia Cotton, CNA
• Kyle Cottone, P.T.
• Counseling & Family Services
• Eva Tarce Counsil, OTR/L

• Chiropractor in Peoria, IL
• Providers in Peoria, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.