Individual provider Active NPI

Fawantina Cockerham

  • Doula
  • Marianna, FL
National Provider Identifier
1114734142
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Practice address
2842 Leland Rd
Marianna, FL 32448-3658
Phone
(850) 867-4287
NPI assigned
Dec 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X Primary

Addresses

Primary practice location

2842 Leland Rd
Marianna, FL 32448-3658

Mailing address

2842 Leland Rd
Marianna, FL 32448-3658
Phone (850) 867-4287

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

NPI Registry JSON

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1114734142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2842 LELAND RD",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324483658",
            "telephone_number": "850-867-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2842 LELAND RD",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324483658",
            "telephone_number": "850-867-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKERHAM",
        "first_name": "FAWANTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.