Individual provider Active NPI

Teresa Jean Cochran, PA

  • Physician Assistant
  • Goldsboro, NC
National Provider Identifier
1962506246
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101516 Issued in NC
Practice address
1100 Parkway Dr Suite C
Goldsboro, NC 27534
Phone
(919) 778-7676
Fax
(919) 778-7665
NPI assigned
Sep 8, 2006
Last updated
Jan 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 101516 NC Primary

Addresses

Primary practice location

1100 Parkway Dr Suite C
Goldsboro, NC 27534

Mailing address

1100 Parkway Dr Ste C
Goldsboro, NC 27534-3477
Phone (919) 778-7676

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
I20081014000204 NC Practitioner - Physician Assistant 9537237870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Care Physicians PAGroup PAC ID 9830265578, 2 clinicians

Practice addresses (Care Compare)

201 Cox Blvd
Goldsboro, NC 27534-9479
Phone (919) 735-7580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
101516NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Goldsboro Wellness Center,PA Past Accepting new patients

Organizations & group practices 3

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296172800000",
    "number": "1962506246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 PARKWAY DR STE C",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275343477",
            "telephone_number": "919-778-7676",
            "fax_number": "919-778-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PARKWAY DR SUITE C",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "27534",
            "telephone_number": "919-778-7676",
            "fax_number": "919-778-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCHRAN",
        "first_name": "TERESA",
        "middle_name": "JEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2011-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

Verify at the official NPI Registry.