Active NPI
Kristine Cottrell
- Licensed Practical Nurse
- Phoenix, AZ
National Provider Identifier
1669708517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP027730
- Practice address
- 2929 E Fillmore St
Phoenix, AZ 85008-6159 - Phone
- (602) 683-2400
- NPI assigned
- Oct 28, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP027730 | AZ | Primary |
Addresses
Primary practice location
2929 E Fillmore St
Phoenix, AZ 85008-6159
Mailing address
2929 E Fillmore Street
Phoenix, AZ 85008
Phone (602) 683-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86000485 | Medicaid | AZ |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP027730 | AZ | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wilson School District | Past | Accepting new patients |
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.
-
- Contractor
- Phoenix, AZ
- NPI 1184763666
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256688000000",
"number": "1669708517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 E FILLMORE STREET",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85008",
"telephone_number": "602-683-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2929 E FILLMORE ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850086159",
"telephone_number": "602-683-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTTRELL",
"first_name": "KRISTINE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-28",
"last_updated": "2009-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AZ",
"license": "LP027730",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "86000485",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.