Individual provider Active NPI

Kerith M.N. Pocock, N.P.

  • Family Nurse Practitioner
  • McDonough, GA
National Provider Identifier
1245679711
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN298763 Issued in GA
Practice address
2 N Zack Hinton Pkwy
McDonough, GA 30253-2317
Phone
(707) 957-2984
NPI assigned
Jun 18, 2013
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-1706 HI
Family Nurse Practitioner 363LF0000X RN298763 GA Primary

Addresses

Primary practice location

2 N Zack Hinton Pkwy
McDonough, GA 30253-2317

Mailing address

2 N Zack Hinton Pkwy
McDonough, GA 30253-2317
Phone (770) 957-2984

Other practice location 1

632 Broadway Ph
New York, NY 10012-2614
Phone (800) 731-4254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160321000577 HI Practitioner - Nurse Practitioner 5991002891 Reassigns benefits to 1 organization
I20210715003269 GA Practitioner - Nurse Practitioner 5991002891 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN298763GAMDFamily Nurse Practitioner
APRN-1706HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pukalani Family Practice, LLC Family CurrentSince Dec 27, 2020 Accepting new patients
Minuteclinic LLC Family CurrentSince Oct 14, 2021 Accepting new patients
Primary Care Physician Enterprise LLC CurrentSince Jun 1, 2020 Accepting new patients
Galileo Medical Group Ga, P.C. CurrentSince Sep 11, 2024 Accepting new patients
Queens University Medical Group PastSince Jun 1, 2020 Accepting new patients

Locations

4300 Paces Ferry Rd SE
Ste 500
Atlanta, GA 30339
Phone (404) 496-8960

2 N Zack Hinton Pkwy
McDonough, GA 30253
Phone (770) 507-0576

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

91-6390 Kapolei Pkwy
Ste 200
Ewa Beach, HI 96706
Phone (612) 802-2986

81 Makawao Ave
Ste 100
Makawao, HI 96768
Phone (808) 573-8900

64 Bleecker St
New York, NY 10012
Phone (302) 313-1584

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCBAAA

Organizations & group practices 5

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": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1245679711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 N ZACK HINTON PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302532317",
            "telephone_number": "770-957-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N ZACK HINTON PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302532317",
            "telephone_number": "707-957-2984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 Broadway Ph",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100122614",
            "country_code": "US",
            "telephone_number": "800-731-4254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POCOCK",
        "first_name": "KERITH",
        "middle_name": "M.N.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-18",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-1706",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN298763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.