NPIMap

Organization Active NPI

Cottage Clinical Network, LLC

Doing business as Cottage Urgent Care

  • Urgent Care Clinic/Center
  • San Luis Obispo, CA
National Provider Identifier
1124643911
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
COTTAGE CLINICAL NETWORK, LLC
Doing business as
Cottage Urgent Care
Practice address
3970 Broad St
San Luis Obispo, CA 93401-7097
Phone
(805) 682-7111
NPI assigned
Jun 8, 2020
Last updated
Jun 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Authorized official

Name
Taryn O'Connell
Title
Administrative Director, Operations
Phone
(805) 729-8013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

3970 Broad St
San Luis Obispo, CA 93401-7097

Mailing address

PO Box 689
Santa Barbara, CA 93102-0689

Other names 1

  • Cottage Urgent Care Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2185986Cottage Urgent Care3970 Broad St, Ste 2, San Luis Obispo, CA 93401Certificate of waiverJun 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Cottage Clinical Network LLC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

3970 Broad St
San Luis Obispo, CA 93401

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1124643911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931020689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 BROAD ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017097",
            "telephone_number": "805-682-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTAGE CLINICAL NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "O'CONNELL",
        "authorized_official_first_name": "TARYN",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR, OPERATIONS",
        "authorized_official_telephone_number": "805-729-8013"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cottage Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.