Individual provider Active NPI

Ethan Joseph Cottrill, MD,PHD

  • Student in an Organized Health Care Education/Training Program
  • Durham, NC
National Provider Identifier
1922543669
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
40 Duke Medicine Cir
Durham, NC 27710-0005
Phone
(919) 684-8111
NPI assigned
Jan 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

40 Duke Medicine Cir
Durham, NC 27710-0005

Mailing address

PO Box 110566
Durham, NC 27709-5566
Phone (919) 620-4855

Other practice location 1

600 N Wolfe St
The Johns Hopkins Hospital
Baltimore, MD 21287-0005
Phone (410) 955-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221216000122 NC Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 7810366713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1922543669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110566",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277095566",
            "telephone_number": "919-620-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 DUKE MEDICINE CIR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100005",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Wolfe St",
            "address_2": "The Johns Hopkins Hospital",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870005",
            "country_code": "US",
            "telephone_number": "410-955-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COTTRILL",
        "first_name": "ETHAN",
        "middle_name": "JOSEPH",
        "credential": "MD,PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.