Vivian Delores Cockrell, SPEECH PATHOLOGIST

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

11960 Westline Industrial Dr
Suite 201
Saint Louis, MO 63146-3209

Phone

(314) 819-0480

Fax

(314) 275-7444

NPI assigned

Sep 4, 2015

Sex

Female

Sole proprietor

Yes

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.

• Supplemental Health Care

  • Physical Therapy Clinic/Center
  • Saint Louis, MO
  • NPI 1700172400
  NPD (past)
• Supplemental Health Care

  • Adult Care Home Facility
  • Saint Louis, MO
  • NPI 1902129653
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

• Miss Vivian Delores Barry Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 4, 2015.

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1740658996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11960 WESTLINE INDUSTRIAL DR",
            "address_2": "SUITE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463209",
            "telephone_number": "314-819-0480",
            "fax_number": "314-275-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11960 WESTLINE INDUSTRIAL DR",
            "address_2": "SUITE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463209",
            "telephone_number": "314-819-0480",
            "fax_number": "314-275-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKRELL",
        "first_name": "VIVIAN",
        "middle_name": "DELORES",
        "name_prefix": "Mrs.",
        "credential": "SPEECH PATHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.000944",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIVIAN",
            "last_name": "BARRY",
            "middle_name": "DELORES",
            "prefix": "MISS",
            "credential": "SPEECH PATHOLOGIST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hunter Cassidy Cochran, MD
• Nicole Renee Cochran, ACNP
• Stephen Edward Cochran, ANP-BC
• Anne Cochrane, MD
• Maurya Cockrell
• Heidi Atwell Coco, DO
• John Codd, MD
• Samantha Codd
• Gloria Shoshana Coden, MD
• Danielle Cody

• All providers in Saint Louis, MO
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; 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.