NPIMap

Individual provider Active NPI

Stephen Michael Cottle, PA-C

  • Surgical Physician Assistant
  • Bozeman, MT
National Provider Identifier
1093979155
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
218 Issued in MT
Practice address
536 Cottonwood Rd.
Suite 100
Bozeman, MT 59718
Phone
(406) 586-8029
Fax
(406) 586-8009
NPI assigned
Jul 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 218 MT Primary
Physician Assistant 363A00000X 002776 GA
Medical Physician Assistant 363AM0700X 002776 GA
Surgical Physician Assistant 363AS0400X 002776 GA

Addresses

Primary practice location

536 Cottonwood Rd.
Suite 100
Bozeman, MT 59718

Mailing address

536 Cottonwood Rd.
Suite 100
Bozeman, MT 59718
Phone (406) 586-8029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
218MTMDAcupuncturist
002776GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Knee and Shoulder Clinic PC Past Accepting new patients
Ortho Montana, PSC Past Accepting new patients

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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1093979155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 COTTONWOOD RD.",
            "address_2": "SUITE 100",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59718",
            "telephone_number": "406-586-8029",
            "fax_number": "406-586-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 COTTONWOOD RD.",
            "address_2": "SUITE 100",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59718",
            "telephone_number": "406-586-8029",
            "fax_number": "406-586-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTLE",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-17",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MT",
            "license": "218",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002776",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "002776",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "002776",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.