John L Cottle, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2004016908 Issued in MO

Practice address

3700 SW Cheddington Dr
Lees Summit, MO 64082-4797

Phone

(816) 623-9990

Fax

(816) 623-9449

NPI assigned

Jul 12, 2005

Last updated

Jul 8, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cottle Optometry, PCGroup PAC ID 9931202165, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

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.

• Cottle Optometry, PC

  dba Summit Lakes Eye Care

  • Optometrist
  • Lee's Summit, MO
  • NPI 1689722324
  Medicare reassignment Care Compare group NPD Authorized official
• Sabates Eye Centers PA

  • Durable Medical Equipment & Medical Supplies
  • Kansas City, MO
  • NPI 1093837528
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1396743472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 SW CHEDDINGTON DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824797",
            "telephone_number": "816-623-9990",
            "fax_number": "816-623-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 SW CHEDDINGTON DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824797",
            "telephone_number": "816-623-9990",
            "fax_number": "816-623-9449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4741 S Arrowhead Dr",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "640556957",
            "country_code": "US",
            "telephone_number": "913-261-2020",
            "fax_number": "913-261-2090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COTTLE",
        "first_name": "JOHN",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2004016908",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1680",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396743472",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Costco Wholesale Corporation
• Costco Wholesale Corporation (Costco Hearing Aid #1838)
• Costco Wholesale Corporation (Costco Optical #1838)
• Carmen Leigh Costello, PHARMD
• Cottle Optometry, PC (Summit Lakes Eye Care)
• Connor Cotton, DPT PT
• Chelsea Coulter
• Jordan Coulter, PLPC
• Courageous Home Care, LLC
• Courageous Trust (Courageous Home Care, LLC)

• Optometrist in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (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.