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KYLE COTNER MD
NPI 1053105734
Student in an Organized Health Care Education/Training Program in Peoria, IL

Active since April 07, 2025PECOS Enrolled
815 MAIN ST STE C, PEORIA, IL 61602(309) 672-4977 Get Directions Write a Review

NPPES record last updated: April 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kyle Cotner Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KYLE COTNER MD (NPI 1053105734) is an individual student in an organized health care education/training program in Peoria, Illinois and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053105734
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameKYLE COTNERCredential: MD
Location Address815 MAIN ST STE CPeoria, IL 61602-1080
Mailing Address544 Woodsdale AveToledo, OH 43609-2960 · (937) 417-9194
Phone(309) 672-4977
Sole ProprietorNo
Enumeration DateApril 7, 2025
NPPES CertifiedApril 7, 2025
✔ NPI 1053105734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
815 MAIN ST STE C, Peoria, IL 61602
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kyle Cotner Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THOMAS TSZ HIM CHOW DO
Student in an Organized Health Care Education/Training Program
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977
DEMI CASTELLANOS
Student in an Organized Health Care Education/Training Program
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977
PATRECE ANTOINETTE BARKER D.O., M.S.
Family Medicine
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4986
PAIGE ELIZABETH BONNER DO
Student in an Organized Health Care Education/Training Program
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977
JEFFREY S. LEMAN MD
Family Medicine
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977
DR. KRISHNA SASANKA BATHINA MD
Family Medicine
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977
RIDA MOHAMMAD GAREEB MD
Family Medicine
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4986
JANTZEN MICHELLE PRIDE MD
Student in an Organized Health Care Education/Training Program
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kyle Cotner's NPI number?

The NPI number for Kyle Cotner is 1053105734. It was assigned to this individual provider in the NPPES registry on April 7, 2025.

Where is Kyle Cotner located?

Kyle Cotner practices at 815 Main St Ste C, Peoria, IL 61602. The listed phone number is (309) 672-4977.

What is Kyle Cotner's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kyle Cotner enrolled in Medicare?

Yes. Kyle Cotner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kyle Cotner was last updated on April 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.