Active NPI
Cyrus A Kotwall, MD
- Surgery Physician
- Wilmington, NC
National Provider Identifier
1124023528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 36371
- Practice address
- 2131 S 17TH St
Wilmington, NC 28401-7407 - Phone
- (910) 343-0161
- Fax
- (910) 772-9452
- NPI assigned
- Jun 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 36371 | NC | Primary |
Addresses
Primary practice location
2131 S 17TH St
Wilmington, NC 28401-7407
Mailing address
2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 343-0161
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Sciences Foundation Inc. | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1124023528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2131 S 17TH ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017407",
"telephone_number": "910-343-0161",
"fax_number": "910-772-9452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2131 S 17TH ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017407",
"telephone_number": "910-343-0161",
"fax_number": "910-772-9452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTWALL",
"first_name": "CYRUS",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "36371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.