Angela E. Cochran, RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN119943NP Issued in GA

Practice address

6635 Lake Dr
Morrow, GA 30260-2354

Phone

(770) 968-1323

Fax

(770) 968-4556

NPI assigned

May 8, 2013

Last updated

Oct 11, 2016By the provider in NPPES

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 2

Other names 1

• Angela E. Kelly Former name

Medicare fee-for-service enrollment

Enrolled in GA

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Truffles Vein Center LLCGroup PAC ID 1355594797, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Truffles Vein Center, LLC

  • Plastic Surgery Physician
  • Fayetteville, GA
  • NPI 1760733448
  Medicare reassignment Care Compare group NPD
• Truffles Vein of Central Georgia LLC

  • Vascular Specialist/Technologist Cardiovascular
  • Powder Springs, GA
  • NPI 1457100430
  Medicare reassignment NPD

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1255776902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6635 LAKE DR",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602354",
            "telephone_number": "770-968-1323",
            "fax_number": "770-968-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6635 LAKE DR",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602354",
            "telephone_number": "770-968-1323",
            "fax_number": "770-968-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCHRAN",
        "first_name": "ANGELA",
        "middle_name": "E.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN119943NP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN119943",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003148111B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003148111A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "KELLY",
            "middle_name": "E.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Clayton Mhddad (Clayton CSB)
• Clayton State University
• Clayton State University
• Clayton State University (clayton state sports medicine)
• CLR Personal Home Care, LLC
• Willie Cochran Jr., MD
• Cognitive Healing of Atlanta LLC
• Terry Cole, LPC, MAC, CCS
• Concentra Health Services, Inc.
• Cool Program Counseling Services, LLC

• Nurse Practitioner in Morrow, GA
• Providers in Morrow, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.