Active NPI
Dustin Cottrell, ATC
- Athletic Trainer
- Roseville, MI
National Provider Identifier
1992162176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2601002079
- Practice address
- 20905 E 12 Mile Rd Ste 200
Roseville, MI 48066-6501 - Phone
- (586) 204-0070
- Fax
- (586) 204-0080
- NPI assigned
- Jan 19, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2601002079 | MI | Primary |
Addresses
Primary practice location
20905 E 12 Mile Rd Ste 200
Roseville, MI 48066-6501
Mailing address
33900 Harper Ave Ste 104
Clinton Township, MI 48035-4258
Phone (586) 350-2644
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2601002079 | MI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772496000000",
"number": "1992162176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33900 HARPER AVE STE 104",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480354258",
"telephone_number": "586-350-2644",
"fax_number": "586-541-3735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20905 E 12 MILE RD STE 200",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480666501",
"telephone_number": "586-204-0070",
"fax_number": "586-204-0080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTTRELL",
"first_name": "DUSTIN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-19",
"last_updated": "2026-03-03",
"certification_date": "2026-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "2601002079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.