NPIMap

Individual provider Active NPI

Jessie Michael Cockrell, MD

  • Family Medicine Physician
  • Senatobia, MS
National Provider Identifier
1285639302
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17248 Issued in MS
Practice address
120 Norfleet Dr
Senatobia, MS 38668-2231
Phone
(662) 301-1128
Fax
(662) 301-4430
NPI assigned
Jun 15, 2005
Last updated
Oct 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17248 MS Primary

Addresses

Primary practice location

120 Norfleet Dr
Senatobia, MS 38668-2231

Mailing address

120 Norfleet Dr
Senatobia, MS 38668-2220
Phone (662) 301-1128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110407000412 MS Practitioner - Family Practice 6305833955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Tennessee, HSC, College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cockrell Family Medical Center PCGroup PAC ID 7517954167, 3 clinicians

Practice addresses (Care Compare)

120 Norfleet Dr
Senatobia, MS 38668-2220
Phone (662) 301-1128

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.06 of 100Reported as group
Quality
72.94
Improvement activities
40
Cost
76.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cockrell Family Medical Center PC CurrentSince Oct 1, 2001 Accepting new patients
Batesville Emergency Physicians Past Accepting new patients
United Emergency Services, Inc. Past Accepting new patients

Locations

120 Norfleet Dr
Senatobia, MS 38668
Phone (662) 301-1128

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Legacy Hospice of the SouthBatesville, MS, CCN 251628 Hospice Contracted Managing Employee Jun 21, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Mercy Hospice, LLC

    dba Legacy Hospice of the South

    • Community Based Hospice Care Agency
    • Batesville, MS
    • NPI 1306141387

    Contracted Managing Employee

    CMS ownership

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1285639302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NORFLEET DR",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386682220",
            "telephone_number": "662-301-1128",
            "fax_number": "662-301-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NORFLEET DR",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386682231",
            "telephone_number": "662-301-1128",
            "fax_number": "662-301-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKRELL",
        "first_name": "JESSIE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "17248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Senatobia, MS

Sources for this page

Verify at the official NPI Registry.