Active NPI
Paul Michael Cockerham, PT
- Physical Therapist
- Chewelah, WA
National Provider Identifier
1356616759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 60238080
- Practice address
- 101 N. Park St.
Chewelah, WA 99109 - Phone
- (509) 935-4988
- NPI assigned
- Mar 19, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 60238080 | WA | Primary |
Addresses
Primary practice location
101 N. Park St.
Chewelah, WA 99109
Mailing address
101 N. Park St.
Chewelah, WA 99109
Phone (509) 935-4988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 60238080 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chewelah Orthopedic & Sports Physical Therapy Inc. | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- Chewelah, WA
- NPI 1235353368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332115200000",
"number": "1356616759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 N. PARK ST.",
"city": "CHEWELAH",
"state": "WA",
"postal_code": "99109",
"telephone_number": "509-935-4988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 N. PARK ST.",
"city": "CHEWELAH",
"state": "WA",
"postal_code": "99109",
"telephone_number": "509-935-4988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COCKERHAM",
"first_name": "PAUL",
"middle_name": "MICHAEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-19",
"last_updated": "2012-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT 60238080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chewelah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.