4D Healthcare, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

4D HEALTHCARE, LLC

Doing business as

4D Healthcare

Practice address

1324 Military Rd
Columbus, MS 39701-3616

Phone

(662) 630-5001

NPI assigned

Feb 14, 2023

Last updated

Apr 25, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Tanya S Cockrell, FNP-BC, PMHNP-BCNPI 1063838480

Title

Owner/Operator

Phone

(662) 630-5001

Specialties & licenses 3

Addresses

Other names 1

• 4D Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tanya Cockrell, FNP

  • Family Nurse Practitioner
  • Columbus, MS
  • NPI 1063838480
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1164129755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 MILITARY RD",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397013616",
            "telephone_number": "662-630-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 MILITARY RD",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397013616",
            "telephone_number": "662-630-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4D HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-14",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A",
        "authorized_official_last_name": "COCKRELL",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "662-630-5001",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-BC, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4D Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 14TH Medgrp-Columbus
• 14TH Medgrp-Columbus (DoD COLUMBUS ePhcy)
• Mohamed Abdel Latif, MD
• Jasen Sisson Abraham, DPT
• Whitney Whiteside Abraham, FNP-C
• Mary E Abrams, CFNP
• Abundant Life Homecare LLC

• Multi-Specialty Clinic/Center in Columbus, MS
• Providers in Columbus, MS by specialty
• Multi-Specialty Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.