Individual provider Active NPI

Gertrude PO Cotiaux, M.D.

  • Family Medicine Physician
  • Boiling Springs, SC
National Provider Identifier
1376525667
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39086 Issued in SC
Practice address
2400 Boiling Springs Rd Ste a
Boiling Springs, SC 29316-5304
Phone
(864) 599-0731
Fax
(864) 599-0791
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-06-7352-C OH
Family Medicine Physician 207Q00000X 39086 SC Primary

Addresses

Primary practice location

2400 Boiling Springs Rd Ste a
Boiling Springs, SC 29316-5304

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6306

Other identifiers 1

IdentifierTypeStateIssuer
2182043MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39086SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Towpath Trail Family Medicine Family Medicine PastSince Feb 2, 2004 Accepting new patients
Lake Anna Primary Care Family Medicine Past Accepting new patients
Orrville Hospital Foundation Past Accepting new patients
Summa Physicians LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gertrude.cotiaux@direct.aultman.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376525667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6306",
            "fax_number": "864-797-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 BOILING SPRINGS RD STE A",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293165304",
            "telephone_number": "864-599-0731",
            "fax_number": "864-599-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTIAUX",
        "first_name": "GERTRUDE",
        "middle_name": "PO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-06-7352-C",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "39086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2182043",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boiling Springs, SC

Sources for this page

Verify at the official NPI Registry.