Phyllis Patricia Coconis, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

171157 Issued in NC

Practice address

2554 Lewisville-Clemmons Rd
Ste 109
Clemmons, NC 27012-8749

Phone

(704) 766-1000

Fax

(704) 766-1002

NPI assigned

Nov 25, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1290643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704067200000",
    "number": "1073815957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 BALFOUR RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043061",
            "telephone_number": "336-408-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 LEWISVILLE-CLEMMONS RD",
            "address_2": "STE 109",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128749",
            "telephone_number": "704-766-1000",
            "fax_number": "704-766-1002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15806 Brookway Dr",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "28078",
            "country_code": "US",
            "telephone_number": "704-766-1000",
            "fax_number": "704-766-1002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10508 Park Road",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28210",
            "country_code": "US",
            "telephone_number": "704-766-1000",
            "fax_number": "704-766-1002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1911 East Broad St",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "28625",
            "country_code": "US",
            "telephone_number": "704-766-1000",
            "fax_number": "704-766-1002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COCONIS",
        "first_name": "PHYLLIS",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-25",
        "last_updated": "2024-01-01",
        "certification_date": "2024-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "171157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; 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.