Individual provider Active NPI

Jessica Ann Cockrill, FNP-C

  • Family Nurse Practitioner
  • Newport News, VA
National Provider Identifier
1154091387
Registry record updated Nov 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024182702 Issued in VA
Practice address
12100 Warwick Blvd Ste 201B
Newport News, VA 23601-2365
Phone
(337) 378-8443
NPI assigned
Sep 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024182702 VA Primary

Addresses

Primary practice location

12100 Warwick Blvd Ste 201B
Newport News, VA 23601-2365

Mailing address

5 Popeley CT
Williamsburg, VA 23188-6406
Phone (337) 378-8443

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211129002467 VA Practitioner - Nurse Practitioner 5193115533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peninsula Cancer Institute, LLCGroup PAC ID 8729031638, 30 clinicians

Practice addresses (Care Compare)

12100 Warwick Blvd
Suite 201
Newport News, VA 23601-2365
Phone (757) 534-5555

Hospital & facility affiliations

  • Riverside Home Health Home health agency, Newport News, VA, CCN 497467
  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Riverside Doctors' Hospital of Williamsburg Hospital, Williamsburg, VA, CCN 490143
  • Riverside Smithfield Hospital Hospital, Smithfield, VA, CCN 490149

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Cancer Institute LLC CurrentSince Nov 1, 2021 Accepting new patients
Peninsula Cancer Institute LLC Past Accepting new patients

Locations

7544 Medical Dr
Ste B
Gloucester, VA 23061
Phone (804) 693-4900

12100 Warwick Blvd
Ste 201B
Newport News, VA 23601
Phone (757) 534-5555

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

12100 Warwick Blvd
Ste 201
Newport News, VA 23601
Phone (757) 534-5555

120 Kings Way
Ste 3100
Williamsburg, VA 23185
Phone (757) 345-5724

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1632009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668816000000",
    "number": "1154091387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 POPELEY CT",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231886406",
            "telephone_number": "337-378-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 WARWICK BLVD STE 201B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236012365",
            "telephone_number": "337-378-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKRILL",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-19",
        "last_updated": "2022-11-19",
        "certification_date": "2022-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024182702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.