Kelli Cockrell, MS, ATC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

080802008 Issued in MS

Practice address

86 Fairway PL
Hattiesburg, MS 39402-3606

Phone

(601) 606-3550

NPI assigned

Jan 16, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1992566178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 FAIRWAY PL",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023606",
            "telephone_number": "601-606-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 FAIRWAY PL",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023606",
            "telephone_number": "601-606-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKRELL",
        "first_name": "KELLI",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MS",
            "license": "080802008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leigh Ann Cochran, FNP-C
• Shelley S Cochran, FNP
• Tracy A Cochran
• William T Cochran Jr., RPT
• John Stephen Cockerham, D.D.S.
• Michael Kaleb Cockrell, DNP, CRNA
• Cassady Coco
• Cohen Podiatry Clinic
• Roland Colburn, DNP, CRNA
• Aaliyah Demi' Cole, OD

• Sports Medicine (Orthopaedic Surgery) Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.