Active NPI
Hubert L. Cockrum OD PA
- Optometrist
- Mountain Home, AR
National Provider Identifier
1801066360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2230
- Legal business name
- HUBERT L. COCKRUM OD PA
- Practice address
- 2183 Highway 62 W
Mountain Home, AR 72653-6500 - Phone
- (870) 425-1112
- Fax
- (870) 425-1278
- NPI assigned
- Mar 11, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Hubert Lawerence Cockrum
- Title
- Doctor
- Phone
- (870) 425-1112
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2230 | AR | Primary |
Addresses
Primary practice location
2183 Highway 62 W
Mountain Home, AR 72653-6500
Mailing address
2183 Highway 62 W
Mountain Home, AR 72653-6500
Phone (870) 425-1112
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44839 | Other | AR | AVESIS |
| P00056615 | Other | AR | RAILROAD MEDICARE |
| 110615722 | Medicaid | AR | |
| 45623 | Other | AR | SPECTERA |
| 97283 | Other | AR | ALWAYS VISION |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205193600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214352000000",
"number": "1801066360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2183 HIGHWAY 62 W",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726536500",
"telephone_number": "870-425-1112",
"fax_number": "870-425-1278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2183 HIGHWAY 62 W",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726536500",
"telephone_number": "870-425-1112",
"fax_number": "870-425-1278"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HUBERT L. COCKRUM OD PA",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-11",
"last_updated": "2008-06-25",
"status": "A",
"authorized_official_last_name": "COCKRUM",
"authorized_official_first_name": "HUBERT",
"authorized_official_middle_name": "LAWERENCE",
"authorized_official_title_or_position": "DOCTOR",
"authorized_official_telephone_number": "870-425-1112",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "AR",
"license": "2230",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVESIS",
"identifier": "44839",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00056615",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110615722",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA",
"identifier": "45623",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALWAYS VISION",
"identifier": "97283",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.