Sally Abbott Cottrell IV

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT21786 Issued in FL

Practice address

394 N Suncoast Blvd
Crystal River, FL 34429-5466

Phone

(352) 795-6225

Fax

(352) 795-6065

NPI assigned

Aug 17, 2007

Last updated

Aug 17, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  Medicare reassignment NPD
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  • Medical Specialty Clinic/Center
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  • NPI 1255630471
  NPD (past)

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1255523890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "394 N SUNCOAST BLVD",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344295466",
            "telephone_number": "352-795-6225",
            "fax_number": "352-795-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 N SUNCOAST BLVD",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344295466",
            "telephone_number": "352-795-6225",
            "fax_number": "352-795-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTRELL",
        "first_name": "SALLY",
        "middle_name": "ABBOTT",
        "name_suffix": "IV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• CRC, Inc (Don's Pharmacy)

• Physical Therapist in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.