Individual provider Active NPI

McKenna Cobb, APRN

  • Family Nurse Practitioner
  • Sebring, FL
National Provider Identifier
1003419383
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11010208 Issued in FL
Practice address
13 Ryant Blvd
Sebring, FL 33870-8075
Phone
(863) 382-4445
NPI assigned
Nov 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11010208 FL Primary

Addresses

Primary practice location

13 Ryant Blvd
Sebring, FL 33870-8075

Mailing address

4267 State Road 66
Zolfo Springs, FL 33890-3704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211108002438 FL Practitioner - Nurse Practitioner 7618366956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana Medical College, School of Medicine of Purdue University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goodlife Healthcare, LLCGroup PAC ID 4688062003, 2 clinicians

Practice addresses (Care Compare)

13 Ryant Blvd
Sebring, FL 33870-8075
Phone (863) 382-4445

Hospital & facility affiliations

  • Adventhealth Sebring Hospital, Sebring, FL, CCN 100109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11010208FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goodlife Healthcare, LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

13 Ryant Blvd
Sebring, FL 33870
Phone (863) 304-8038

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1003419383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4267 STATE ROAD 66",
            "city": "ZOLFO SPRINGS",
            "state": "FL",
            "postal_code": "338903704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 RYANT BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338708075",
            "telephone_number": "863-382-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "MCKENNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11010208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.