Holly Demarest Kockler, RN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

200736 Issued in NC

Practice address

1141 N. Road St., Ste K
Carolina Coastal Plastic Surgery
Elizabeth City, NC 27909

Phone

(252) 335-2293

Fax

(252) 331-2387

NPI assigned

Sep 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2255/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.

• Carolina Coastal Plastic Surgery, PC

  • Plastic Surgery Physician
  • Elizabeth City, NC
  • NPI 1417282401
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1245322981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 N. ROAD ST., STE K",
            "address_2": "CAROLINA COASTAL PLASTIC SURGERY",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "27909",
            "telephone_number": "252-335-2293",
            "fax_number": "252-331-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 N. ROAD ST., STE K",
            "address_2": "CAROLINA COASTAL PLASTIC SURGERY",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "27909",
            "telephone_number": "252-335-2293",
            "fax_number": "252-331-2387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCKLER",
        "first_name": "HOLLY",
        "middle_name": "DEMAREST",
        "name_prefix": "Ms.",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NC",
            "license": "082463",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "200736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBOM NP PRACTICE NUMBER",
            "identifier": "200736",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE NUMBER",
            "identifier": "082463",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZF0000131",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debracca King, FNP-C
• Kathryn Jones King, MD
• Richard Christian King, D.P.M.
• Paul Andrew Kizen, MD
• David Wesley Kleinschuster, PSY. D, M.ED, M.A.
• Jenna Nicole Kockott
• Jamie Koller
• Vincent J Kopp, MD
• Jennifer Ashley Kramer, M.S. CCC-SLP
• Alexandra W Kroeff, PA

• Family Nurse Practitioner in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.