Individual provider Active NPI

Cody Tyler Cottrell, DNP, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • North Little Rock, AR
National Provider Identifier
1669155305
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
225806 Issued in AR
Practice address
513 Main St
North Little Rock, AR 72114-5329
Phone
(501) 777-5969
NPI assigned
Aug 9, 2023
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 225806 AR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 225806 AR Primary

Addresses

Primary practice location

513 Main St
North Little Rock, AR 72114-5329

Mailing address

1748 Edgeburg LN
Cordova, TN 38016-3550
Phone (901) 591-7144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325000366 TN Practitioner - Nurse Practitioner 2860839081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathways to Wellness LLCGroup PAC ID 8224481148, 8 clinicians

Practice addresses (Care Compare)

65 Germantown CT
Suite 207
Cordova, TN 38018-4258
Phone (901) 878-3332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
225806ARMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways to Wellness LLC Psychiatric/Mental Health CurrentSince Mar 8, 2024 Accepting new patients
McCoy Counseling LLC CurrentSince Aug 13, 2023 Accepting new patients
Mental Wellness Connection CurrentSince Mar 20, 2025 Accepting new patients

Locations

11215 Hermitage Rd
Ste 204
Little Rock, AR 72211
Phone (501) 283-7201

65 Germantown Ct
Ste 207
Cordova, TN 38018
Phone (901) 878-3332

Organizations & group practices 3

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": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1669155305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1748 EDGEBURG LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380163550",
            "telephone_number": "901-591-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 MAIN ST",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721145329",
            "telephone_number": "501-777-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTRELL",
        "first_name": "CODY",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "225806",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "225806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.