Individual provider Active NPI

Lisa Michele Cottrill, NURSE PRACTITIONER C

  • Family Nurse Practitioner
  • Glenville, WV
National Provider Identifier
1013947894
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33513 Issued in WV
Practice address
921 Mineral Rd
Ste 101
Glenville, WV 26351-1342
Phone
(304) 364-1093
Fax
(304) 364-1050
NPI assigned
Jul 4, 2006
Last updated
Mar 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 33513 WV Primary

Addresses

Primary practice location

921 Mineral Rd
Ste 101
Glenville, WV 26351-1342

Mailing address

921 Mineral Rd
# 101
Glenville, WV 26351-1342
Phone (304) 364-1093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110610000497 WV Practitioner - Nurse Practitioner 8820275258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
West Virginia University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

80 Spring Run Rd
Arnoldsburg, WV 25234-7096
Phone (304) 354-5995

921 Mineral Rd
Suite 101
Glenville, WV 26351-1342
Phone (304) 462-7322

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
33513WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minnie Hamilton Health Care Center, Inc. CurrentSince Jun 1, 2013 Accepting new patients
Minnie Hamilton Health Care Center, Inc. CurrentSince Jun 1, 2013 Accepting new patients
Minnie Hamilton Health Care Center, Inc. Past Accepting new patients
Minnie Hamilton Health Care Center, Inc. Past Accepting new patients

Locations

376 WV Highway 5 E
Glenville, WV 26351
Phone (304) 462-7322

921 Mineral Rd
#101
Glenville, WV 26351
Phone (304) 462-7322

921 Mineral Rd
Ste 101
Glenville, WV 26351
Phone (304) 462-7322

186 Hospital Dr
Grantsville, WV 26147
Phone (304) 354-9244

Interoperability endpoints

  • Direct secure messaging: lisa.cottrill.1@14266.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1013947894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 MINERAL RD",
            "address_2": "# 101",
            "city": "GLENVILLE",
            "state": "WV",
            "postal_code": "263511342",
            "telephone_number": "304-364-1093",
            "fax_number": "304-364-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 MINERAL RD",
            "address_2": "STE 101",
            "city": "GLENVILLE",
            "state": "WV",
            "postal_code": "263511342",
            "telephone_number": "304-364-1093",
            "fax_number": "304-364-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTRILL",
        "first_name": "LISA",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "33513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenville, WV

Sources for this page

Verify at the official NPI Registry.