John Ernest Cottle Jr., D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A10161 Issued in CA

Practice address

721 River Dr
Suite a
Fort Bragg, CA 95437

Phone

(707) 961-4631

Fax

(707) 964-1192

NPI assigned

Oct 2, 2006

Last updated

Oct 19, 2012By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Osteopathic Manipulative Medicine

Education

Oklahoma State University College of Osteopathic Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adventist Health Mendocino CoastGroup PAC ID 3678990769, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Mendocino Coast Hospital, Fort Bragg, CA, CCN 051325

Merit-based Incentive Payment System (MIPS)

Final score

80.98 of 100Reported as group

Quality

73.31

Promoting interoperability

92

Improvement activities

40

Cost

62

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/29a5ccea-f4ab-4447-a191-56b20695970f/

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.

• Adventist Health Mendocino Coast

  dba Mendocino Coast District Hospital

  • Critical Access Hospital
  • Fort Bragg, CA
  • NPI 1538113725
  Medicare reassignment Care Compare group
• Adventist Health Mendocino Coast

  dba Mendocino Coast District Hospital

  • Rural Health Clinic/Center
  • Fort Bragg, CA
  • NPI 1124220249
  NPD
• Doug Johnson MD PC

  • Gynecology Physician
  • Buena Vista, CO
  • NPI 1184741837
  NPD (past)
• Mountain Medical Center of Buena Vista, PC

  • Family Medicine Physician
  • Buena Vista, CO
  • NPI 1386728640
  NPD (past)

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

• Adventist Health Mendocino Coast

  dba Mendocino Coast District Hospital

  • Critical Access Hospital
  • Fort Bragg, CA
  • NPI 1538113725
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1447343116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 RIVER DR",
            "address_2": "SUITE A",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-961-4631",
            "fax_number": "707-964-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 RIVER DR",
            "address_2": "SUITE A",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-961-4631",
            "fax_number": "707-964-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTLE",
        "first_name": "JOHN",
        "middle_name": "ERNEST",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A10161",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "34047",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01340470",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Functional Medicine
• Code 3 Mind Health, Inc.
• Abraham P Cohen, CMT
• Tabetha Connell
• Phillip Conwell Jr., CRNA
• County of Mendocino
• County of Mendocino
• Courtney Morgan Cravens, MPH, PA-C
• Sean Crawford
• Donna Louise Crikos, RPT

• Family Medicine Physician in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.