Kevin Cotter Odpa

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-935 Issued in ID

Legal business name

KEVIN COTTER ODPA

Practice address

5108 Cleveland Blvd
Caldwell, ID 83607-8002

Phone

(208) 455-2197

Fax

(208) 455-2198

NPI assigned

Jul 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Cotter, ODNPI 1124121058

Title

Owner

Phone

(208) 455-2197

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Charles Cotter, O.D.

  • Optometrist
  • Caldwell, ID
  • NPI 1124121058
  NPD (past) Authorized official

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1245420926",
    "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 CLEVELAND BLVD",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836078002",
            "telephone_number": "208-455-2197",
            "fax_number": "208-455-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN COTTER ODPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "COTTER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-455-2197",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "1592829",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Merle L. Keller III, MD
• Tatiana Marie Kennedy
• Colt Kennington
• Randon Kessinger
• Keven Freeman DMD PLLC
• Mark Keylor, LMSW
• Leila Khaddour, MD
• Kimberly Drewrey, Aprn, NP-C
• L. Mark Kimsey, M.D.
• Kindred Nursing Centers West, LLC

• 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 27, 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.