Individual provider Active NPI

Channing Jovi Cochran, PSY.D.

  • Clinical Psychologist
  • Salt Lake City, UT
National Provider Identifier
1053947804
Registry record updated Jan 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
11454015-2501 Issued in UT
Practice address
500 Foothill Blvd
Salt Lake City, UT 84148-0001
Phone
(801) 582-1565
NPI assigned
Mar 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 11454015-2501 UT Primary

Addresses

Primary practice location

500 Foothill Blvd
Salt Lake City, UT 84148-0001

Mailing address

5114 Medical Dr Apt 2352
San Antonio, TX 78229-3878
Phone (256) 651-0089

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CCOCHRAN610051@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: ccochran610051@direct.med.utah.edu

NPI Registry JSON

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673136000000",
    "number": "1053947804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5114 MEDICAL DR APT 2352",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293878",
            "telephone_number": "256-651-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-582-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCHRAN",
        "first_name": "CHANNING",
        "middle_name": "JOVI",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2023-01-08",
        "certification_date": "2023-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "11454015-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CCOCHRAN610051@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.