Individual provider Active NPI

Kellie Annette Cochran, A.N.P

  • Adult Health Nurse Practitioner
  • Clayton, NC
National Provider Identifier
1861725491
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5004471 Issued in NC
Practice address
34 Healthpark Way Ste 100C
Clayton, NC 27520-4497
Phone
(919) 585-8850
Fax
(919) 585-8869
NPI assigned
Sep 15, 2009
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5004471 NC Primary

Addresses

Primary practice location

34 Healthpark Way Ste 100C
Clayton, NC 27520-4497

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442
Phone (984) 215-4110

Other identifiers 3

IdentifierTypeStateIssuer
1861725491MedicaidNC
5004471OtherNCNC STATE LICENSE #
173XPOtherNCBCBS OF NC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcochran219444@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20091109000046 NC Practitioner - Nurse Practitioner 5991843153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

34 Healthpark Way
Clayton, NC 27520-4497
Phone (919) 585-8850

37 Pineville Blvd
Clayton, NC 27527-9355

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514-2601
Phone (919) 942-5123

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5004471NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Select Specialty Hospital - Durham Inc. CurrentSince Feb 14, 2018 Accepting new patients
Vidant Medical Group LLC CurrentSince Feb 5, 2017 Accepting new patients
Unc Physicians Network LLC CurrentSince Feb 24, 2021 Accepting new patients
Unc Physicians Network LLC Current Accepting new patients
Raleigh Durham Medical Group PA PastSince Jul 25, 2021 Accepting new patients
Dudley B. Anderson, M.D., P.a. Past Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

34 Healthpark Way
Ste 100C
Clayton, NC 27520
Phone (919) 585-8850

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

1041 Noell Ln
Ste 105
Rocky Mount, NC 27804
Phone (252) 442-9600

Interoperability endpoints

  • Direct secure messaging: kcochran219444@direct.unc.nchie.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1861725491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442",
            "telephone_number": "984-215-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 HEALTHPARK WAY STE 100C",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204497",
            "telephone_number": "919-585-8850",
            "fax_number": "919-585-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCHRAN",
        "first_name": "KELLIE",
        "middle_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "credential": "A.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5004471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861725491",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE #",
            "identifier": "5004471",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "173XP",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcochran219444@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "34 Healthpark Way Ste 100C",
            "city": "Clayton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275204497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.