Individual provider Active NPI

Kelly M McCockran, APRN, CNP

  • Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1427513795
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.024227 Issued in OH
Practice address
33 W Rahn Rd
Dayton, OH 45429-2219
Phone
(937) 433-8990
Fax
(937) 433-8691
NPI assigned
Jan 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.024227 OH Primary
Hospitalist Physician 208M00000X APRN.CNP.024227 OH
Registered Nurse 163W00000X RN.335087 OH

Addresses

Primary practice location

33 W Rahn Rd
Dayton, OH 45429-2219

Mailing address

33 W Rahn Rd
Dayton, OH 45429-2219
Phone (937) 433-8990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190814001955 OH Practitioner - Nurse Practitioner 1254668254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Dayton Acute Care Consultants, IncGroup PAC ID 3577452465, 116 clinicians

Practice addresses (Care Compare)

33 W Rahn Rd
Dayton, OH 45429-2219
Phone (937) 433-8990

Hospital & facility affiliations

  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Merit-based Incentive Payment System (MIPS)

Final score
91.82 of 100Reported as group
Quality
79.31
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.335087OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
South Dayton Acute Care Consultants, Inc Hospitalist CurrentSince Jun 15, 2019 Accepting new patients

Locations

33 W Rahn Rd
#101
Dayton, OH 45429
Phone 9374338990102

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

33 W Rahn Rd
Kettering, OH 45429
Phone 9374338990 ext. 102

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 3

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": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1427513795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W RAHN RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292219",
            "telephone_number": "937-433-8990",
            "fax_number": "937-433-8691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W RAHN RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292219",
            "telephone_number": "937-433-8990",
            "fax_number": "937-433-8691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOCKRAN",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.024227",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "APRN.CNP.024227",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.335087",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.