Corinne Patricia Bottrell, PH.D., N.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

Practice address

547 S Fitness PL Ste 110
Eagle, ID 83616-6552

Phone

(208) 939-3986

NPI assigned

Dec 7, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Eagle Sport & Family Chiropractic PLLC

  • Sports Physician Chiropractor
  • Eagle, ID
  • NPI 1861574410
  NPD

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

{
    "created_epoch": "1575676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575676800000",
    "number": "1861039943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3896 HOLL DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836162850",
            "telephone_number": "208-440-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 S FITNESS PL STE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166552",
            "telephone_number": "208-939-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTRELL",
        "first_name": "CORINNE",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "PH.D., N.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-07",
        "last_updated": "2019-12-07",
        "certification_date": "2019-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Bonfrisco
• Cody Johanna Bonine, FNP
• Nathaniel Bonovitz, LCPC
• Raydell Booth, PH.D.
• Ella Boothby
• Timothy L Bowers, PSYD
• Harry R Boyd III, MD
• John Christopher Boyd
• Aubree Bradshaw
• McKinley Bradshaw, LPC

• Cognitive & Behavioral Psychologist in Eagle, ID
• Providers in Eagle, ID by specialty
• Cognitive & Behavioral Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2019; 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.