Calvin John Cogburn, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP30007600 Issued in WA

Practice address

1155 SE City Beach St
Unit 915
Oak Harbor, WA 98277-7009

Phone

(360) 969-0915

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Conquer Addiction PLLCGroup PAC ID 8325562044, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Conquer Addiction PLLC

  • Multi-Specialty Clinic/Center
  • Monroe, WA
  • NPI 1255001624
  Medicare reassignment Care Compare group
• Shifa Health PLLC

  • Cognitive & Behavioral Psychologist
  • Mount Vernon, WA
  • NPI 1356415327
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1184764284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 915",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982770915",
            "telephone_number": "360-969-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 SE CITY BEACH ST",
            "address_2": "UNIT 915",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982777009",
            "telephone_number": "360-969-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGBURN",
        "first_name": "CALVIN",
        "middle_name": "JOHN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30007600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarity Counseling
• Martin Thomas Clark, DDS
• Carol Clayton, RN, MSW
• Chanel J Clayton
• Kelsey Anne Coffman
• Rhonda L Coker, RN
• Mark Vernon Colaianni, D.M.D.
• Mistie Dawn Coleman
• Martin Anand Collier, M.D.
• Alexandra Anderson Colvin, M.S.

• Psychiatric/Mental Health Nurse Practitioner in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.