Active NPI
Stephanie Elaine Cottrell, LMT
- Massage Therapist
- Bend, OR
National Provider Identifier
1366057358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 21127
- Practice address
- 587 NE Greenwood Ave Ste B
Bend, OR 97701-4609 - Phone
- (541) 915-2745
- NPI assigned
- Sep 15, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 21127 | OR | Primary |
Addresses
Primary practice location
587 NE Greenwood Ave Ste B
Bend, OR 97701-4609
Mailing address
14765 S Sugar Pine Way
La Pine, OR 97739-9434
Phone (541) 915-2745
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21127 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703116800000",
"number": "1366057358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14765 S SUGAR PINE WAY",
"city": "LA PINE",
"state": "OR",
"postal_code": "977399434",
"telephone_number": "541-915-2745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "587 NE GREENWOOD AVE STE B",
"city": "BEND",
"state": "OR",
"postal_code": "977014609",
"telephone_number": "541-915-2745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTTRELL",
"first_name": "STEPHANIE",
"middle_name": "ELAINE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-15",
"last_updated": "2023-12-21",
"certification_date": "2023-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "21127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.