Active NPI
Bruce Sheldon Kottler, PH.D.
- Clinical Psychologist
- Fort Bragg, NC
National Provider Identifier
1710101019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4491
- Practice address
- 2817 Rock Merritt Ave Womack Army Medical Center
Fort Bragg, NC 28310-0001 - Phone
- (910) 907-8922
- Fax
- (910) 907-6069
- NPI assigned
- Apr 11, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4491 | NC | Primary |
Addresses
Primary practice location
2817 Rock Merritt Ave Womack Army Medical Center
Fort Bragg, NC 28310-0001
Mailing address
2817 Rock Merritt Ave Womack Army Medical Center
Fort Bragg, NC 28310-0001
Phone (910) 907-8922
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4491 | NC | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coleman Professional Services, Inc. | Psychologist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1710101019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-8922",
"fax_number": "910-907-6069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-8922",
"fax_number": "910-907-6069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTTLER",
"first_name": "BRUCE",
"middle_name": "SHELDON",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-11",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "4491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bragg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.