Individual provider Active NPI

Jonathan Michael Cotteen, CRNA

  • Certified Registered Nurse Anesthetist
  • Coeur d'Alene, ID
National Provider Identifier
1609314517
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
55015 Issued in ID
Practice address
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone
(208) 625-6400
NPI assigned
Feb 10, 2017
Last updated
Nov 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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 55015 ID Primary

Addresses

Primary practice location

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Mailing address

PO Box 35145 #40023
Seattle, WA 98124-5145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boise Anesthesia, P a Nurse Anesthetist, Certified Registered CurrentSince May 29, 2017 Accepting new patients
Anesthesia Associates of Coeur D Alene PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 10, 2018 Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1609314517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35145 #40023",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTEEN",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-10",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "55015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.