Individual provider Active NPI

Eranesha L Cochran, PA-C, MS, RD

  • Physician Assistant
  • North Little Rock, AR
National Provider Identifier
1063718633
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-705 Issued in AR
Practice address
2200 Fort Roots Dr
North Little Rock, AR 72114-1709
Phone
(501) 257-3932
NPI assigned
Jan 31, 2011
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-705 AR Primary
Registered Dietitian 133V00000X 1121 AR

Addresses

Primary practice location

2200 Fort Roots Dr
North Little Rock, AR 72114-1709

Mailing address

169 Kentucky Cir
Jacksonville, AR 72076-1027
Phone (832) 289-7702

Other practice location 1

1701 S Shackleford Rd
Little Rock, AR 72211-4335
Phone (501) 219-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20170508001109 AR Practitioner - Physician Assistant 6002193737 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
1121ARMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Heart Hospital, LLC CurrentSince Apr 2, 2017 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Apr 12, 2017 Accepting new patients

Locations

1701 S Shackleford Rd
Little Rock, AR 72211
Phone (501) 219-7000

7 Shackleford West Blvd
Little Rock, AR 72211
Phone (501) 614-3671

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1063718633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 KENTUCKY CIR",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720761027",
            "telephone_number": "832-289-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FORT ROOTS DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721141709",
            "telephone_number": "501-257-3932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 S Shackleford Rd",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722114335",
            "country_code": "US",
            "telephone_number": "501-219-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COCHRAN",
        "first_name": "ERANESHA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MS, RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-31",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-705",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AR",
            "license": "1121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.