Active NPI
Cameron Cottrell, DPT
- Physical Therapist
- Jacksonville, FL
National Provider Identifier
1952857047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT34536
- Practice address
- 1036 Dunn Ave
Jacksonville, FL 32218 - Phone
- (904) 903-5520
- Fax
- (904) 903-5525
- NPI assigned
- Aug 29, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT34536 | FL | Primary |
| Physical Therapist | 225100000X | 070022609 | IL |
Addresses
Primary practice location
1036 Dunn Ave
Jacksonville, FL 32218
Mailing address
1036 Dunn Ave
Jacksonville, FL 32218-6349
Phone (904) 903-5520
Other practice location 1
1036 Dunn Ave
Jacksonville, FL 32218
Phone (904) 903-5520
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT34536 | FL | MD | Physical Therapist |
| 070022609 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565827200000",
"number": "1952857047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1036 DUNN AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322186349",
"telephone_number": "904-903-5520",
"fax_number": "904-903-5525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1036 DUNN AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32218",
"telephone_number": "904-903-5520",
"fax_number": "904-903-5525"
}
],
"practiceLocations": [
{
"address_1": "1036 Dunn Ave",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "32218",
"country_code": "US",
"telephone_number": "904-903-5520",
"fax_number": "904-903-5525",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COTTRELL",
"first_name": "CAMERON",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-29",
"last_updated": "2019-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT34536",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070022609",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.