Individual provider Active NPI

Lillian Cockrell, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1306399662
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1090406 Issued in AL
Practice address
813 Franklin St SE
Huntsville, AL 35801-4311
Phone
(256) 519-3650
NPI assigned
Aug 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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 1-090406 AL
Family Nurse Practitioner 363LF0000X 1090406 AL Primary

Addresses

Primary practice location

813 Franklin St SE
Huntsville, AL 35801-4311

Mailing address

813 Franklin St SE
Huntsville, AL 35801-4311

Other practice location 1

4040 Memorial Pkwy SW
Huntsville, AL 35802-4364
Phone (256) 533-1970

Other identifiers 1

IdentifierTypeStateIssuer
528400480MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20170329000922 AL Practitioner - Nurse Practitioner 7911282298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstone, Inc.Group PAC ID 9739070046, 18 clinicians

Practice addresses (Care Compare)

4040 Memorial Pkwy SW
Huntsville, AL 35802-4364
Phone (256) 533-1970

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1090406ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstone, Inc. CurrentSince Apr 4, 2019 Accepting new patients

Locations

4040 Memorial Pkwy SW
Huntsville, AL 35802
Phone (256) 533-1970

1131 Eagletree Ln SW
Ste 300
Huntsville, AL 35801

Interoperability endpoints

  • Direct secure messaging: ldcockrell@hi-al.direct.office.nextgen.com

Organizations & group practices 1

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 1

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": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1306399662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 FRANKLIN ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 FRANKLIN ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014311",
            "telephone_number": "256-519-3650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4040 Memorial Pkwy SW",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358024364",
            "country_code": "US",
            "telephone_number": "256-533-1970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COCKRELL",
        "first_name": "LILLIAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-090406",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1090406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528400480",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.