Cockerell & McIntosh Pediatrics, PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2016036885 Issued in MO

Legal business name

COCKERELL & MCINTOSH PEDIATRICS, PC

Practice address

205 NW R D Mize Rd
Ste 304
Blue Springs, MO 64014-2515

Phone

(816) 228-4770

Fax

(816) 228-1156

NPI assigned

Feb 17, 2017

Last updated

Feb 17, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bryan E Wood

Title

Practice Administrator

Phone

(816) 228-4770

Specialties & licenses 1

Addresses

Tax ID family

Cockerell McIntosh Pediatric Urgent Ca2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Cockerell & McIntosh Pediatrics PC

  • Primary Care Clinic/Center
  • Blue Springs, MO
  • NPI 1124190632
  NPD tax ID

Locations

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1629517107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 NW R D MIZE RD",
            "address_2": "STE 304",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142515",
            "telephone_number": "816-228-4770",
            "fax_number": "816-228-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 NW R D MIZE RD",
            "address_2": "STE 304",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142515",
            "telephone_number": "816-228-4770",
            "fax_number": "816-228-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COCKERELL & MCINTOSH PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-17",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "816-228-4770"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2016036885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CMC Chiropractic LLC
• CMC Comprehensive Care Blue Springs LLC (Core Medical Center)
• CMC Physical and Occupational Therapy
• CMC Walk in Med BS LLC (CMC Walk in Medical)
• Cockerell & McIntosh Pediatrics PC
• Charles Frederick Cockerell, MD
• Heather Lynn Colbert
• Tatum Brianne Colburn, DO
• Sara Jane Cole, PSY.D.
• Glenn Mark Collet, PSYCHOLOGIST

• Pediatric Nurse Practitioner in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.