Individual provider Active NPI

Nicole Dean Cochran, PT

  • Physical Therapist
  • Puyallup, WA
National Provider Identifier
1306415526
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61171535 Issued in WA
Practice address
2930 S Meridian Ste 120
Puyallup, WA 98373-1654
Phone
(253) 445-2733
Fax
(253) 445-2399
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 61171535 WA Primary

Addresses

Primary practice location

2930 S Meridian Ste 120
Puyallup, WA 98373-1654

Mailing address

2930 S Meridian Ste 120
Puyallup, WA 98373-1654
Phone (253) 445-2733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210728000123 WA Practitioner - Physical Therapist in Private Practice 4385047406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2930 S Meridian
Suite 120
Puyallup, WA 98373-1654
Phone (253) 445-2733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61171535WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Outpatient Physical Therapy & Sports Rehabilitation Inc PC Physical Therapist CurrentSince Jul 14, 2021 Accepting new patients

Locations

8009 S 180th St
Ste 112
Kent, WA 98032
Phone (253) 833-8766

26837 Maple Valley Black Diamond Rd SE
Ste 200
Maple Valley, WA 98038
Phone (425) 413-4425

2930 S Meridian
Ste 120
Puyallup, WA 98373
Phone (253) 445-2733

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.

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1306415526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 S MERIDIAN STE 120",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983731654",
            "telephone_number": "253-445-2733",
            "fax_number": "253-445-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 S MERIDIAN STE 120",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983731654",
            "telephone_number": "253-445-2733",
            "fax_number": "253-445-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCHRAN",
        "first_name": "NICOLE",
        "middle_name": "DEAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "61171535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.