Individual provider Active NPI

Shannon Williams-Cochran

  • Licensed Practical Nurse
  • Fort Valley, GA
National Provider Identifier
1073305066
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN096721 Issued in GA
Practice address
2004 Carver Dr
Fort Valley, GA 31030-4443
Phone
(478) 718-8793
NPI assigned
May 19, 2025
Last updated
May 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X LPN096721 GA
Diabetes Educator Registered Nurse 163WD0400X LPN096721 GA
Peritoneal Dialysis Registered Nurse 163WD1100X LPN096721 GA
Enterostomal Therapy Registered Nurse 163WE0900X LPN096721 GA
Home Health Registered Nurse 163WH0200X LPN096721 GA
Hospice Registered Nurse 163WH1000X LPN096721 GA
Infusion Therapy Registered Nurse 163WI0500X LPN096721 GA
Medical-Surgical Registered Nurse 163WM0705X LPN096721 GA
Wound Care Registered Nurse 163WW0000X LPN096721 GA
Licensed Practical Nurse 164W00000X LPN096721 GA Primary
Lactation Consultant (Non-RN) 174N00000X LPN096721 GA
Pediatric Hospice and Palliative Medicine Physician 2080H0002X LPN096721 GA

Addresses

Primary practice location

2004 Carver Dr
Fort Valley, GA 31030-4443

Mailing address

2004 Carver Dr
Fort Valley, GA 31030-4443
Phone (478) 718-8793

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN096721GAMDEnterostomal Therapy Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Fruit of the Spirit Companion Services CurrentSince May 25, 2025 Accepting new patients
Fruit of the Spirit Companion Services PastSince May 25, 2025 Accepting new patients

Organizations & group practices 2

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": "1747612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1073305066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 CARVER DR",
            "city": "FORT VALLEY",
            "state": "GA",
            "postal_code": "310304443",
            "telephone_number": "478-718-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 CARVER DR",
            "city": "FORT VALLEY",
            "state": "GA",
            "postal_code": "310304443",
            "telephone_number": "478-718-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS-COCHRAN",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "GA",
            "license": "LPN096721",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "GA",
            "license": "LPN096721",
            "primary": false
        },
        {
            "code": "163WD1100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Dialysis, Peritoneal",
            "state": "GA",
            "license": "LPN096721",
            "primary": false
        },
        {
            "code": "163WE0900X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Enterostomal Therapy",
            "state": "GA",
            "license": "LPN096721",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "GA",
            "license": "LPN096721",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "GA",
            "license": "LPN096721",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "GA",
            "license": "LPN096721",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "GA",
            "license": "LPN096721",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "GA",
            "license": "LPN096721",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN096721",
            "primary": true
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "GA",
            "license": "LPN096721",
            "primary": false
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "LPN096721",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Valley, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.