NPI profile
JACKSON COTHREN
NPI record status, taxonomy, official source timestamp, and OIG LEIE screening context.
Identity
- NPI
- 1104829340
- Entity type
- NPI-1
- Primary taxonomy
- 207VG0400X
- NPI source updated
- Mar 22, 2021
- Enumeration date
- May 23, 2005
- Cache fetched
- May 05, 2026
NPI does not validate licensure, credentialing, Medicare enrollment, or current practice authority.
OIG LEIE screening
No current OIG match foundConfidence: none
No OIG LEIE match found in the current imported dataset. Verify against the official OIG source for compliance decisions.
NPI addresses
| Purpose | Address | Phone |
|---|---|---|
| MAILING | 6158516033 | |
| LOCATION | 6158152350 |
FAQ
Practical notes
Does an NPI record validate licensure?
No. NPI data does not validate licensure, credentialing, Medicare enrollment, or current practice authority.