Individual provider Active NPI

Caleb Henry Cotner, DO

  • Family Medicine Physician
  • Bridgeport, WV
National Provider Identifier
1487396206
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4663 Issued in WV
Practice address
1511 Johnson Ave Ste 104
Bridgeport, WV 26330-1016
Phone
(681) 342-3700
NPI assigned
Apr 12, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4663 WV Primary

Addresses

Primary practice location

1511 Johnson Ave Ste 104
Bridgeport, WV 26330-1016

Mailing address

201 S Rogers Rd.
Apt. S294
Hot Springs, AR 71913
Phone (479) 214-3809

Other practice location 1

527 Medical Park Dr
Bridgeport, WV 26330-9008
Phone (681) 342-3600

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250729000250 WV Practitioner - Family Practice 8729595467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Physicians Care IncGroup PAC ID 6103814017, 119 clinicians

Practice addresses (Care Compare)

1511 Johnson Ave
Suite 104
Bridgeport, WV 26330-1016
Phone (681) 342-3700

Hospital & facility affiliations

  • United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Physicians Care Inc Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
United Physicians Care Inc Family Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

1511 Johnson Ave
Ste 104
Bridgeport, WV 26330
Phone (304) 848-0702

2373 W Main St
Ste 102
Salem, WV 26426
Phone (304) 782-2000

Organizations & group practices 2

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 1

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": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1487396206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S ROGERS RD.",
            "address_2": "APT. S294",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "71913",
            "telephone_number": "479-214-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 JOHNSON AVE STE 104",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301016",
            "telephone_number": "681-342-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "527 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "WV",
            "postal_code": "263309008",
            "country_code": "US",
            "telephone_number": "681-342-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COTNER",
        "first_name": "CALEB",
        "middle_name": "HENRY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-12",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "4663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.