Active NPI
Gwendolyn D Harris-Cocroft, FNP
- Family Nurse Practitioner
- Hattiesburg, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R859966
- Practice address
- 605 Stadium Dr
Hattiesburg, MS 39401-4156 - Phone
- (601) 450-0310
- Fax
- (601) 450-0321
- NPI assigned
- Mar 31, 2011
- Sex
- Female
- Sole proprietor
- No
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 and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Magee, MS
- NPI 1235669136
-
- Urgent Care Clinic/Center
- Picayune, MS
- NPI 1780723502
-
- Rural Health Clinic/Center
- Ripley, MS
- NPI 1447769559
-
- Nurse Practitioner
- Parsons, TN
- NPI 1063843951
-
- Urgent Care Clinic/Center
- Hattiesburg, MS
- NPI 1164805156
-
- Rural Health Clinic/Center
- Kosciusko, MS
- NPI 1851050579
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Hattiesburg, MS
- NPI 1821490723
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Maxem Health Urgent Care MageePicayune Urgent Care Clinic, LLC
Practice addresses (Care Compare)
1529 Simpson Hwy 49
Magee, MS 39111-4209
Phone (601) 439-7288
422 Memorial Blvd
Picayune, MS 39466-5544
Phone (601) 798-2151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130123000339 | MS | Practitioner - Nurse Practitioner | 5395998421 | Reassigns benefits to 5 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Mississippi, PLLC | Family | Current | Accepting new patients |
| Fast Pace Mississippi, PLLC | Current | Accepting new patients | |
| Truhealth, LLC | Current | Accepting new patients | |
| The University of Southern Mississippi | Past | Accepting new patients |
Locations
1506 N Main St
Columbia, MS 39429
Phone (601) 735-9557
517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206
925 Calhoun Ave
Yazoo City, MS 39194
Phone (662) 746-6651
1971 Tennessee Ave N
Parsons, TN 38363
Phone (731) 614-1424
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R859966 | MS | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
605 Stadium Dr
Hattiesburg, MS 39401-4156
Mailing address
PO Box 1729
Hattiesburg, MS 39403-1729
Phone (601) 545-3700
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07474202 | Medicaid | MS |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 4, 2013.
{
"created_epoch": "1301529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359936000000",
"number": "1659660512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1729",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394031729",
"telephone_number": "601-545-3700",
"fax_number": "601-450-2493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 STADIUM DR",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394014156",
"telephone_number": "601-450-0310",
"fax_number": "601-450-0321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS-COCROFT",
"first_name": "GWENDOLYN",
"middle_name": "D",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-31",
"last_updated": "2013-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R859966",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07474202",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.