William Forrest Cothern, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

F9330 Issued in TX

Practice address

4201 Camp Bowie Blvd
Ste a
Fort Worth, TX 76107-3928

Phone

(817) 377-1243

Fax

(817) 763-0631

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Enrolled in TX

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

Specialty

Dermatology

Education

University of North Texas HSC, College of Osteopathic Med, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Oliver Street 5.01(a) Inc.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment Care Compare group NPD
• William F. Cothern,D.O.,P.a.

  • Dermatology Physician
  • Ft Worth, TX
  • NPI 1295034924
  NPD (past) Authorized official
• Dermatology Associates

  • Dermatology Physician
  • Houston, TX
  • NPI 1356523039
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501804800000",
    "number": "1962493445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 CAMP BOWIE BLVD",
            "address_2": "STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073928",
            "telephone_number": "817-377-1243",
            "fax_number": "817-763-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 CAMP BOWIE BLVD",
            "address_2": "STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073928",
            "telephone_number": "817-377-1243",
            "fax_number": "817-763-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTHERN",
        "first_name": "WILLIAM",
        "middle_name": "FORREST",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2017-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "F9330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Leah Klyce Cothran, LPC, LCDC
• Michael Patrick Cotter, M.D.
• Thomas G Cotter, MD
• Catherine Cottle Basma
• Tonya K Cottle Fuqua, D.D.S.

• Dermatology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.