Individual provider Active NPI

Terry Willard Cottrell, D.C.

  • Chiropractor
  • Issaquah, WA
National Provider Identifier
1043423783
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002014 Issued in WA
Practice address
140 6TH Ave NE
Issaquah, WA 98027-3341
Phone
(425) 392-9490
Fax
(425) 427-6401
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00002014 WA Primary

Addresses

Primary practice location

140 6TH Ave NE
Issaquah, WA 98027-3341

Mailing address

6520 226TH PL SE
Suite# 203
Issaquah, WA 98027-8969
Phone (425) 392-9490

Other identifiers 1

IdentifierTypeStateIssuer
CH00002014OtherWACHIROPRACTIC LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120201000297 WA Practitioner - Chiropractic 6901063007 Reassigns benefits to 1 organization
Practice locations: Issaquah, WA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

140 6TH Ave NE
Issaquah, WA 98027-3341
Phone (425) 392-9490

6520 226TH PL SE
Issaquah, WA 98027-8969
Phone (425) 392-9490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00002014WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cottrell Chiropractic PS Chiropractor CurrentSince Aug 1, 2022 Accepting new patients
Wadsworth Psychiatric Services PLLC PastSince Dec 16, 2020 Accepting new patients

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1043423783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 226TH PL SE",
            "address_2": "SUITE# 203",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278969",
            "telephone_number": "425-392-9490",
            "fax_number": "425-427-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 6TH AVE NE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273341",
            "telephone_number": "425-392-9490",
            "fax_number": "425-427-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTRELL",
        "first_name": "TERRY",
        "middle_name": "WILLARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "CH00002014",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.