Sally L. Coburn, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

335 Issued in AK

Practice address

3300 Arctic Blvd
Ste 101
Anchorage, AK 99503-4523

Phone

(907) 561-3488

Fax

(907) 562-3488

NPI assigned

Apr 6, 2007

Last updated

Aug 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Coburn Health Consulting LLC

  • Clinic/Center
  • Anchorage, AK
  • NPI 1871020123
  NPD Authorized official
• MD Inc

  dba Alaska Premier Health

  • Internal Medicine Physician
  • Anchorage, AK
  • NPI 1003914094
  NPD (past)
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1063535045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18828 MOOSE PL",
            "city": "CHUGIAK",
            "state": "AK",
            "postal_code": "995676645",
            "telephone_number": "907-854-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 ARCTIC BLVD",
            "address_2": "STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034523",
            "telephone_number": "907-561-3488",
            "fax_number": "907-562-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "SALLY",
        "middle_name": "L.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "335",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Wellness and Counseling, LLC
• Stacy Coates
• Farrell Cobbs Jr.
• Margaret M. Cobey, RN ANP
• Coburn Health Consulting LLC
• Amanda Lynn Cochran
• Haley A Cochran, PA-C
• Travis Eugene Cockerham
• Ann Cockrell
• Melissa Norma Cockrell, APRN, NP-C

• Family Nurse Practitioner in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Family Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.