Michelle Heidi Kotkin, DC – Chiropractor

Key facts

NPI: 1376520718
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: 0104001317 (VA)
Practice address: 1809 Plaza Dr
Winchester, VA 22601
Phone: (540) 667-7300
Fax: (540) 667-0567
NPI assigned: Dec 28, 2005
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

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.

Kotkin Chiropractic Center PLC Chiropractor · Winchester, VA · NPI 1508950452

Medicare reassignment NPD Authorized official CHIROPRACTOR · VA

Medicare Care Compare profile

Specialty: Chiropractic
Education: Palmer College Chiropractic - West Sunnyvale, 1994
Medicare assignment: Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1809 Plaza Dr
Winchester, VA 22601-6365
Phone (540) 667-7300

Medicare participation

Medicare fee-for-service enrollment: Enrolled in VA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20120326000435	VA	Practitioner - Chiropractic	4486547890	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Kotkin Chiropractic Center PLC	Chiropractor	Current since Jun 1, 1999	Accepting new patients

Locations

1809 Plaza Dr
Winchester, VA 22601
Phone (540) 667-7300

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	0104001317	VA	Yes

Addresses

Primary practice location

1809 Plaza Dr
Winchester, VA 22601

Mailing address

1809 Plaza Dr
Winchester, VA 22601
Phone (540) 667-7300

Other identifiers

Identifier	Type	State	Issuer
0300055	Medicaid	VA
14521	Other	VA	OPTIMA
203058	Other		ANTHEM
0132119000	Medicaid	WV
505187	Other		HEALTH LINK NCPPO
601858500	Other		US DEPT OF LABOR

Other names

Mrs. Michelle Kotkin Cornette Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 19, 2010.

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1376520718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 PLAZA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "22601",
            "telephone_number": "540-667-7300",
            "fax_number": "540-667-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 PLAZA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "22601",
            "telephone_number": "540-667-7300",
            "fax_number": "540-667-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTKIN",
        "first_name": "MICHELLE",
        "middle_name": "HEIDI",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0300055",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "14521",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "203058",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0132119000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH LINK NCPPO",
            "identifier": "505187",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "601858500",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "CORNETTE",
            "middle_name": "KOTKIN",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Winchester, VA

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Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.