Individual provider Active NPI

James Vance Cockerham III, APRN

  • Acute Care Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1720745953
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN11016311 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 303-7283
Fax
(407) 303-0347
NPI assigned
Nov 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11016311 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

2501 N Orange Ave Ste 401
Orlando, FL 32804-4644
Phone (407) 303-7283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220103000686 FL Practitioner - Nurse Practitioner 6103217039 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgical Associates LLCGroup PAC ID 4082634407, 52 clinicians

Practice addresses (Care Compare)

6440 W Newberry Rd
Suite 102
Gainesville, FL 32605-4368
Phone (352) 333-5610

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11016311FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgical Associates LLC CurrentSince Nov 7, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 14, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 14, 2022 Accepting new patients

Locations

6440 W Newberry Rd
Ste 102
Gainesville, FL 32605
Phone (352) 333-5610

1121 NW 64th Ter
Ste B
Gainesville, FL 32605
Phone (352) 331-6777

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

2501 N Orange Ave
Ste 401
Orlando, FL 32804

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: james.cockerham@hca5.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1720745953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 401",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044644",
            "telephone_number": "407-303-7283",
            "fax_number": "407-303-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-303-7283",
            "fax_number": "407-303-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKERHAM",
        "first_name": "JAMES",
        "middle_name": "VANCE",
        "name_suffix": "III",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11016311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.