MR. JERRY A KOTULLA (NPI# 1457312506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457312506 |
| Entity Type | Individual |
| Full Name | MR. JERRY A KOTULLA |
| Credential | M,D. |
| Practice Address |
7 Glenn Bridge Rd Suite C Arden NC 28704-3322 |
| Mailing Address |
7 Glenn Bridge Rd Ste C Arden NC 28704-3333 |
| Practice Telephone | 8286549080 |
| Practice Fax Number | 8286549030 |
| Mailing Telephone | 8286549080 |
| Mailing Fax Number | 8286549030 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2013-06-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
9600597 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 89130EY | 05 |
| Street Address |
7 GLENN BRIDGE RD SUITE C |
| City | ARDEN |
| State | NC |
| Zip Code | 28704-3322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023283355 | Antoinette W. Wall, M.d. Pa | Preferred Provider Organization | 7 Glenn Bridge Rd, Ste D, Arden, NC 28704-3322 | 2008-04-28 |
| 1023044534 | Total Care Services, Inc. | Durable Medical Equipment & Medical Supplies | 7 Glenn Bridge Rd, Suite A, Arden, NC 28704-3322 | 2006-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801410949 | Lindsey Marie Gates | Dentist | 226 New Airport Rd Ste 30, Arden, NC 28704 | 2020-06-04 |
| 1669025565 | Casey Cho Dds Pllc | Dentist | 150 Airport Rd. Suite 30, Arden, NC 28704 | 2019-07-19 |
| 1700370913 | Eric Seth Shapiro | Chiropractor | 32 Southwicke Dr, Arden, NC 28704 | 2018-06-20 |
| 1285180406 | Adam Herbst | Physical Therapy Assistant | 101 Roberts Lake Circle Apt 105, Arden, NC 28704 | 2016-08-28 |
| 1760820013 | Dove Shoneman | Acupuncturist | 600 Julian Lane, Suite 660, Arden, NC 28704 | 2013-06-10 |
| 1710288378 | Higher Ground Pediatric Therapy, Pllc | Community/Behavioral Health | 3749 Sweeten Creek Road Suites 1-2, Arden, NC 28704 | 2010-11-12 |
| 1962642868 | Pandora M Hodge | Physician Assistant | 436 Airport Road, Suite 20, Arden, NC 28704 | 2009-03-05 |
| 1710135009 | Wal-mart Stores, Inc. | Eyewear Supplier (Equipment, not the service) | 60 Airport Rd., Asheville, NC 28704 | 2008-08-29 |
| 1679732598 | Patty Ann Dalton | Social Worker | 126 Locust Court, Arden, NC 28704 | 2008-06-05 |
| 1053501783 | Roger A Wallace | Psychologist | 410 Mills Gap Rd., Arden, NC 28704 | 2007-07-30 |
| Find all providers in zip 28704 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073897716 | Comprehensive Pain Consultants of The Carolinas, Pllc | Anesthesiology | 26 Glen Cove Dr, Arden, NC 28704-3219 | 2011-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174164057 | Regenerative Medical Institute,pllc | Anesthesiology | 1305 W. Wendover Ave., Ste A, Greensboro, NC 27408 | 2019-10-02 |
| 1598235830 | Mission Community Anesthesiology Specialists LLC | Anesthesiology | 89 Hospital Dr Ste C, Brevard, NC 28712-4838 | 2018-11-29 |
| 1508341736 | Bethany Medical Center | Anesthesiology | 190 Independence Ave Ste B, North Wilkesboro, NC 28659-4270 | 2018-10-03 |
| 1508347048 | Premier Pain Solutions Pllc | Anesthesiology | 5710 Oleander Dr Ste 201, Wilmington, NC 28403-4722 | 2018-08-23 |
| 1417434069 | Kyle Mason Fisher | Anesthesiology | Duke Univeristy Hospital Anesthesia Department, Durham, NC 27710-0001 | 2018-07-26 |
| 1306351432 | Carteret Surgical Associates P.a. | Anesthesiology | 2145 Country Club Rd Ste 400, Jacksonville, NC 28546-2400 | 2017-12-12 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1205372588 | Interventional Pain Center, Pllc | Anesthesiology | 517 B Hwy 210 N, Spring Lake, NC 28390 | 2017-01-11 |
| 1316482201 | Providence Pain, Spine & Recovery, Pllc | Anesthesiology | 7 Berkshire Rd, Smithfield, NC 27577 | 2016-12-30 |
| 1356898720 | Ketamine Wellness Institute | Anesthesiology | 414 Cosgrove Ave, Chapel Hill, NC 27514-5271 | 2016-09-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.