NPIMap

Individual provider Active NPI

Andrea M Zockoll, CRNP

  • Family Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1881054989
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R200671 Issued in MD
Practice address
1665 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone
(410) 546-6650
Fax
(410) 546-2656
NPI assigned
Mar 2, 2016
Last updated
Nov 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R200671 MD Primary

Addresses

Primary practice location

1665 Woodbrooke Dr
Salisbury, MD 21804-8502

Mailing address

PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015

Other identifiers 1

IdentifierTypeStateIssuer
119591300MedicaidMD

Other names 1

  • Ms. Andrea Jochum Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418001621 MD Practitioner - Nurse Practitioner 9830497254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12137 Elm St
Princess Anne, MD 21853-1358
Phone (410) 651-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Three Lower Counties Community Services, Inc. CurrentSince Apr 25, 2016 Accepting new patients
Three Lower Counties Community Services Inc Current Accepting new patients
Three Lower Counties Community Services, Inc. CurrentSince Apr 25, 2016 Accepting new patients
Three Lower Counties Community Services, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

12137 Elm St
Princess Anne, MD 21853
Phone (410) 651-1000

12145 Elm St
Princess Anne, MD 21853
Phone (410) 651-2204

1665 Woodbrooke Dr
Salisbury, MD 21804
Phone (410) 546-6650

32033 Beaver Run Dr
Salisbury, MD 21804
Phone (410) 860-6600

Interoperability endpoints

  • Direct secure messaging: andrea.zockoll.1@3167.direct.athenahealth.com

Organizations & group practices 5

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 5

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": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1881054989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 WOODBROOKE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218048502",
            "telephone_number": "410-546-6650",
            "fax_number": "410-546-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOCKOLL",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-02",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R200671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "JOCHUM",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.