Individual provider Active NPI

Marvin Cotten, PA

  • Physician Assistant
  • Kings Mountain, NC
National Provider Identifier
1083873541
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06861 Issued in NC
Practice address
706 W King St
Kings Mountain, NC 28086-2708
Phone
(980) 487-5470
NPI assigned
Jun 9, 2008
Last updated
Jan 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-06861 NC Primary

Addresses

Primary practice location

706 W King St
Kings Mountain, NC 28086-2708

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ambulatory@direct.carolinashealthcare.org Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170223002393 NC Practitioner - Physician Assistant 9739113291 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-06861NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Dec 19, 2016 Accepting new patients
Carolinas Medical Center CurrentSince Dec 19, 2016 Accepting new patients
Albert Boyd MD PA Past Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

706 W King St
Kings Mtn, NC 28086
Phone (704) 730-5108

Interoperability endpoints

  • Direct secure messaging: ambulatory@direct.carolinashealthcare.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1083873541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 W KING ST",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280862708",
            "telephone_number": "980-487-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTEN",
        "first_name": "MARVIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "706 W King St",
            "city": "Kings Mountain",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280862708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kings Mountain, NC

Sources for this page

Verify at the official NPI Registry.