Individual provider Active NPI

Stacie Smith Cockerham, NP

  • Nurse Practitioner
  • High Point, NC
National Provider Identifier
1306438304
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5014106 Issued in NC
Practice address
601 N Elm St
High Point, NC 27262-4331
Phone
(336) 878-6000
Fax
(336) 878-6010
NPI assigned
Feb 10, 2021
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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 5014106 NC Primary
Acute Care Nurse Practitioner 363LA2100X 5014106 NC

Addresses

Primary practice location

601 N Elm St
High Point, NC 27262-4331

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-2255

Other practice location 1

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000

Other practice location 2

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-7224

Other practice location 3

612 Mocksville Ave
Salisbury, NC 28144-2732
Phone (704) 210-5260

Other practice location 4

190 Kimel Park Dr Ste 155
Winston Salem, NC 27103-6946
Phone (336) 765-6637

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
I20210312000353 NC Practitioner - Nurse Practitioner 8527474766 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

175 Kimel Park Dr
Winston Salem, NC 27103-6951
Phone (336) 718-1006

190 Kimel Park Dr
Suite 155
Winston Salem, NC 27103-6946
Phone (336) 765-6637

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 16, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 16, 2023 Accepting new patients
Forsyth Memorial Hospital, Inc CurrentSince Jun 2, 2023 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Jun 2, 2023 Accepting new patients
Forsyth Memorial Hospital, Inc Past Accepting new patients

Locations

152 E Kinderton Way
Ste 101
Bermuda Run, NC 27006
Phone (336) 893-3180

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

1918 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 384-9437

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

175 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 718-1006

190 Kimel Park Dr
Ste 155
Winston Salem, NC 27103
Phone (336) 765-6637

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Interoperability endpoints

  • Direct secure messaging: scockerham2876920@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: scockerham779960@direct.novanthealth.org

Organizations & group practices 7

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 2

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": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1306438304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N ELM ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624331",
            "telephone_number": "336-878-6000",
            "fax_number": "336-878-6010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Elm St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011004",
            "country_code": "US",
            "telephone_number": "336-832-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Silas Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033013",
            "country_code": "US",
            "telephone_number": "336-718-7224",
            "fax_number": "336-718-7598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "612 Mocksville Ave",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281442732",
            "country_code": "US",
            "telephone_number": "704-210-5260",
            "fax_number": "704-210-5265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "190 Kimel Park Dr Ste 155",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036946",
            "country_code": "US",
            "telephone_number": "336-765-6637",
            "fax_number": "336-765-6964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COCKERHAM",
        "first_name": "STACIE",
        "middle_name": "SMITH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5014106",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5014106",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.