Kevin Charles Cotter, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-935 Issued in ID

Practice address

5108 E Cleveland Blvd
Caldwell, ID 83605-8002

Phone

(208) 455-2197

NPI assigned

Sep 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kevin Cotter Odpa Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kevin Cotter Odpa

  • Optometrist
  • Caldwell, ID
  • NPI 1245420926
  NPD (past) Authorized official

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124121058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 WINTHER BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836516542",
            "telephone_number": "208-466-1395",
            "fax_number": "208-466-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 E CLEVELAND BLVD",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836058002",
            "telephone_number": "208-455-2197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTER",
        "first_name": "KEVIN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEVIN",
            "last_name": "COTTER ODPA",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Core Dynamics LLC
• Core Medicine Idaho, LLC
• Natalie Anne Cortes, RN
• Reylene Monique Cortes
• Nichole Ruth Cortez, RDN
• County of Canyon Canyon Co School Dist 132
• George Thomas Cox III, PT
• Cpapnow, Inc.
• Travis Blake Craig, DPT
• Trevor J Crapo, PA

• Optometrist in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.