Individual provider Active NPI

Alicea Jaklyn Cottingham, CRNA

  • Certified Registered Nurse Anesthetist
  • Oklahoma City, OK
National Provider Identifier
1427308329
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
82351 Issued in OK
Practice address
9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone
(405) 715-3610
NPI assigned
Sep 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 82351 OK Primary

Addresses

Primary practice location

9600 Broadway Ext
Oklahoma City, OK 73114-7408

Mailing address

PO Box 13618
Oklahoma City, OK 73113-1618
Phone (405) 715-3610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140812000714 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739306903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Professionals PLLCGroup PAC ID 5991970279, 103 clinicians

Practice addresses (Care Compare)

4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7000

4801 Integris Pkwy
Edmond, OK 73034-8864
Phone (405) 713-4565

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
82351OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Professionals, PLLC CurrentSince Feb 1, 2015 Accepting new patients

Locations

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1427308329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13618",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731131618",
            "telephone_number": "405-715-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-715-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTINGHAM",
        "first_name": "ALICEA",
        "middle_name": "JAKLYN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "82351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.