Jill Cottel MD, in.

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

65247 Issued in CA

Legal business name

JILL COTTEL MD, IN.

Doing business as

Poway Integrative Medicine Center

Practice address

12630 Monte Vista Rd
209
Poway, CA 92064-2530

Phone

(858) 312-1672

NPI assigned

Feb 24, 2009

Last updated

May 5, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Other names 1

• Poway Integrative Medicine Center Doing business as

Part of

Medvantx Inc

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jill S Cottel, MD

  • Internal Medicine Physician
  • Yorktown, VA
  • NPI 1083682272
  NPD (past)

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1750521241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 SCRANTON RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921217701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12630 MONTE VISTA RD",
            "address_2": "209",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642530",
            "telephone_number": "858-312-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL COTTEL MD, IN.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2009-02-24",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "65247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poway Integrative Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Helena Jayasuriya, L.C.S.W.
• Jennifer Pack, Nurse Practitioner, Apc
• Jami Jennings, MA, PPS CREDENTIAL
• Tamrah Jennings, FNP-C
• Jenny Raz Licensed Clinical Social Worker
• Jill D. Paisley, Professional Chiropractic Corporation
• Jill S Cottell M D a Professional Corporation
• Priscilla Jimenez
• Silberio Jimenez
• Nallely Jiminez

• Non-Pharmacy Dispensing Site in Poway, CA
• Providers in Poway, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.