Individual provider Active NPI

Cheryl Anne Cockram, PHD.,ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1174577399
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1944112 Issued in FL
Practice address
10770 N 46TH St
Tampa, FL 33617-3442
Phone
(813) 903-3615
NPI assigned
May 20, 2006
Last updated
Jun 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1944112 FL Primary

Addresses

Primary practice location

10770 N 46TH St
Tampa, FL 33617-3442

Mailing address

5009 Paloma Dr
Tampa, FL 33624-4343
Phone (813) 903-3615

Other identifiers 1

IdentifierTypeStateIssuer
305697000MedicaidFL

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)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc Past Accepting new patients
Psychological Management Group, PA Past Accepting new patients
Stephen J Szabo MD PA Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1174577399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5009 PALOMA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336244343",
            "telephone_number": "813-903-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10770 N 46TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336173442",
            "telephone_number": "813-903-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKRAM",
        "first_name": "CHERYL",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PHD.,ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "1944112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305697000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.