Individual provider Active NPI

Amy H Cochran, M.D.

  • Pediatrics Physician
  • Gainesville, GA
National Provider Identifier
1114903689
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
38518 Issued in GA
Practice address
1485 Jesse Jewell Pkwy NE
Suite 200
Gainesville, GA 30501-3801
Phone
(770) 534-5255
Fax
(770) 287-3871
NPI assigned
Dec 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 38518 GA Primary

Addresses

Primary practice location

1485 Jesse Jewell Pkwy NE
Suite 200
Gainesville, GA 30501-3801

Mailing address

1485 Jesse Jewell Pkwy NE
Suite 200
Gainesville, GA 30501-3801
Phone (770) 534-5255

Other identifiers 2

IdentifierTypeStateIssuer
003180245AMedicaidGA
2008249018MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150504000849 VA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0446206056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38518GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates LLP Pediatrics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1114903689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 JESSE JEWELL PKWY NE",
            "address_2": "SUITE 200",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013801",
            "telephone_number": "770-534-5255",
            "fax_number": "770-287-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 JESSE JEWELL PKWY NE",
            "address_2": "SUITE 200",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013801",
            "telephone_number": "770-534-5255",
            "fax_number": "770-287-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCHRAN",
        "first_name": "AMY",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "38518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003180245A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2008249018",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.