Susan Cockburn, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

R052096 Issued in GA

Practice address

1105 Burleyson Rd
Dalton, GA 30720-3017

Phone

(706) 278-4640

Fax

(706) 275-6599

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4044/brand/1/csg/1/fhir/r4

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.

• Associates in Obstetrics & Gynecology, PC

  • Obstetrics & Gynecology Physician
  • Dalton, GA
  • NPI 1750482048
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194861435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 BURLEYSON RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203017",
            "telephone_number": "706-278-4640",
            "fax_number": "706-275-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 BURLEYSON RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203017",
            "telephone_number": "706-278-4640",
            "fax_number": "706-275-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKBURN",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "R052096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00367661A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krista Renae Clark, M.S. CCC-SLP
• Toby Johnson Clarkson, DMD
• Kelly Elaine Cline, CPNP-PC
• Callie Cobb, CRNA
• Holly Michelle Cochran, FNP-C
• Jeffrey L Cohen, DO
• Hugh M. Coke III, MD
• Kirsten Anne Coker
• Tiffany Ann Coker, COTA
• Betul Colakoglu

• All providers in Dalton, GA
• Advanced Practice Midwife in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.