Active NPI
Donna G Cobb, FNP
- Family Nurse Practitioner
- Petal, MS
National Provider Identifier
1972510212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R592153
- Practice address
- 50 Parkway LN Ste B
Petal, MS 39465-3035 - Phone
- (601) 705-2897
- Fax
- (601) 584-6457
- NPI assigned
- Aug 1, 2006
- Last updated
- Jul 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R592153 | MS | |
| Family Nurse Practitioner | 363LF0000X | R592153 | MS | Primary |
Addresses
Primary practice location
50 Parkway LN Ste B
Petal, MS 39465-3035
Mailing address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 795-0659
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00118666 | Medicaid | MS | |
| 640507572KY | Other | MS | AMERICAN ADMIN GROUP |
| 1791211 | Medicaid | LA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dcobb2499@directpatientrecord.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R592153 | MS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hattiesburg Clinic PA | Past | Accepting new patients | |
| The University of Southern Mississippi | Past | Accepting new patients | |
| Hattiesburg Clinic PA | Past | Accepting new patients |
Interoperability endpoints
- dcobb2499@directpatientrecord.com
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.
-
- Family Medicine Physician
- Poplarville, MS
- NPI 1720188907
-
dba Petal Family Practice Clinic
- Family Medicine Physician
- Petal, MS
- NPI 1831299130
-
dba USM Sports Medicine and Rehabilitation
- Sports Medicine (Orthopaedic Surgery) Physician
- Hattiesburg, MS
- NPI 1821490723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595203200000",
"number": "1972510212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 S 28TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017246",
"telephone_number": "601-795-0659",
"fax_number": "601-579-5240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 PARKWAY LN STE B",
"city": "PETAL",
"state": "MS",
"postal_code": "394653035",
"telephone_number": "601-705-2897",
"fax_number": "601-584-6457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBB",
"first_name": "DONNA",
"middle_name": "G",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2020-07-20",
"certification_date": "2020-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "R592153",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R592153",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00118666",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN ADMIN GROUP",
"identifier": "640507572KY",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1791211",
"state": "LA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dcobb2499@directpatientrecord.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "50 Parkway Ln Ste B",
"city": "Petal",
"state": "MS",
"country_code": "US",
"postal_code": "394653035",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Petal, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.