Individual provider Active NPI

Boni Lee Killian-Cobb, FNP

  • Family Nurse Practitioner
  • Hickory, NC
National Provider Identifier
1255783346
Registry record updated Dec 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008706 Issued in NC
Practice address
212 29TH Ave NE
Suite 1
Hickory, NC 28601-1084
Phone
(828) 326-0658
Fax
(828) 326-7105
NPI assigned
Jul 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 237415 NC
Family Nurse Practitioner 363LF0000X 5008706 NC Primary

Addresses

Primary practice location

212 29TH Ave NE
Suite 1
Hickory, NC 28601-1084

Mailing address

212 29TH Ave NE
Suite 1
Hickory, NC 28601-1084
Phone (828) 732-5350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20161003000037 NC Practitioner - Nurse Practitioner 9638466865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catawba Valley Medical Group IncGroup PAC ID 6305007279, 133 clinicians

Practice addresses (Care Compare)

212 29TH Ave NE
Hickory, NC 28601-1084
Phone (828) 732-5350

Hospital & facility affiliations

  • Gentiva Health Services Home health agency, Hickory, NC, CCN 347300
  • Bayada Home Health Care, Inc Home health agency, Salisbury, NC, CCN 347325
  • Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5008706NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Group, Inc Current Accepting new patients
Catawba Valley Medical Group Inc CurrentSince Aug 29, 2016 Accepting new patients
Catawba Valley Medical Group, Inc CurrentSince Aug 29, 2016 Accepting new patients
Catawba Valley Medical Group, Inc Past Accepting new patients

Locations

200 Rosenwald School St
Catawba, NC 28609
Phone (828) 241-2377

212 29th Ave NE
Ste 1
Hickory, NC 28601
Phone (828) 326-0658

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

50 Macedonia Church Rd
#A
Taylorsville, NC 28681
Phone (828) 732-5300

Interoperability endpoints

  • Direct secure messaging: boni.killian@cvmg.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734220800000",
    "number": "1255783346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 29TH AVE NE",
            "address_2": "SUITE 1",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286011084",
            "telephone_number": "828-732-5350",
            "fax_number": "828-732-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 29TH AVE NE",
            "address_2": "SUITE 1",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286011084",
            "telephone_number": "828-326-0658",
            "fax_number": "828-326-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLIAN-COBB",
        "first_name": "BONI",
        "middle_name": "LEE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2024-12-15",
        "certification_date": "2024-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "237415",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.