Glenn Cottrill

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

POR31 Issued in FL

Practice address

930 Mar Walt Dr Ste D
Ft. Walton Beach, FL 32547

Phone

(850) 863-5959

Fax

(850) 863-5977

NPI assigned

May 11, 2010

Last updated

Mar 31, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Bay Prosthetic Center

  • Prosthetic/Orthotic Supplier
  • Fort Walton Beach, FL
  • NPI 1346245081
  NPD Authorized official
• Bay Quality Prosthetics LLC

  • Customized Equipment (DME)
  • Panama City, FL
  • NPI 1003117466
  NPD Authorized official

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1396063772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 MAR WALT DR STE D",
            "city": "FT. WALTON BEACH",
            "state": "FL",
            "postal_code": "32547",
            "telephone_number": "850-863-5959",
            "fax_number": "850-863-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MAR WALT DR STE D",
            "city": "FT. WALTON BEACH",
            "state": "FL",
            "postal_code": "32547",
            "telephone_number": "850-863-5959",
            "fax_number": "850-863-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTRILL",
        "first_name": "GLENN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-11",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "POR31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Ilana Cope
• Crystal Gillette Copeland
• David I Copeland, MA
• Kendall Gail Corman II
• Caitlyn Marie-Rose Corn, RBT
• Rachel L Couch, ARNP
• Counseling Inc., Dba Alliance Counseling
• Bridget Counterman, RN
• Katharine Ann Couvillon
• Covenant Hospice Inc

• Durable Medical Equipment & Medical Supplies in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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.