1720652274 NPI number — NIKKI COTTEN WESTBROOK MD

Table of content: NIKKI COTTEN WESTBROOK MD (NPI 1720652274)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720652274 NPI number — NIKKI COTTEN WESTBROOK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WESTBROOK
Provider First Name:
NIKKI
Provider Middle Name:
COTTEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720652274
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/12/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3051
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCK HILL
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29732-5051
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-784-8731
Provider Business Mailing Address Fax Number:
803-987-8288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
534 RIVER CROSSING DR STE 206
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT MILL
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29715-7900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-784-8731
Provider Business Practice Location Address Fax Number:
803-987-8288
Provider Enumeration Date:
05/19/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  MD86031 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 860313 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com