Organization Active NPI

Jan Hagwood Cocke, M.a., CCC-SLP, LLC

  • Speech-Language Pathologist
  • Orangeburg, SC
National Provider Identifier
1780058578
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3546 Issued in SC
Legal business name
JAN HAGWOOD COCKE, M.A., CCC-SLP, LLC
Practice address
3221 Plum Cir
Orangeburg, SC 29118-3148
Phone
(803) 378-7459
Fax
(803) 536-4922
NPI assigned
Nov 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Authorized official

Name
Jan Hagwood Cocke, M.A. CCC-SLP
Title
Owner
Phone
80337487459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 3546 SC Primary

Addresses

Primary practice location

3221 Plum Cir
Orangeburg, SC 29118-3148

Mailing address

3221 Plum Cir
Orangeburg, SC 29118-3148
Phone (803) 378-7459

Other identifiers 1

IdentifierTypeStateIssuer
SA0548MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447718400000",
    "number": "1780058578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 PLUM CIR",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291183148",
            "telephone_number": "803-378-7459",
            "fax_number": "803-536-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 PLUM CIR",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291183148",
            "telephone_number": "803-378-7459",
            "fax_number": "803-536-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN HAGWOOD COCKE, M.A., CCC-SLP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-17",
        "last_updated": "2015-11-17",
        "status": "A",
        "authorized_official_last_name": "COCKE",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "HAGWOOD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "80337487459",
        "authorized_official_credential": "M.A. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA0548",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.