MS. KAITLYN ELIZABETH COCKERHAM (NPI# 1174147102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174147102 |
| Entity Type | Individual |
| Full Name | MS. KAITLYN ELIZABETH COCKERHAM |
| Credential | PA-C |
| Practice Address |
3643 N Roxboro St Durham NC 27704-2702 |
| Mailing Address |
622 E Whitaker Mill Rd Raleigh NC 27608-2636 |
| Practice Telephone | 9194704000 |
| Mailing Telephone | 3364073633 |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2020-06-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
0010-09836 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3643 N ROXBORO ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27704-2702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033113899 | Nirmish Shah | Internal Medicine | 3643 N Roxboro St, Durham, NC 27704-2702 | 2005-06-09 |
| 1548872633 | Christopher James Rogge | Nurse Anesthetist, Certified Registered | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-08-19 |
| 1801404579 | Grace L Johnson | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-07-20 |
| 1306466859 | Keri Laurelle Konstant | Registered Nurse | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-04-24 |
| 1194351262 | Deidre Pelletier | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-03-20 |
| 1720618812 | Elizabeth Parker Sulentic | Nurse Practitioner | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-01-17 |
| 1265079131 | Melinda Yvonne House | Nurse Practitioner | 3643 N Roxboro St, Durham, NC 27704-2702 | 2019-12-10 |
| 1427607811 | Grace Amy Revenaugh Dreyer | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2019-09-09 |
| 1841848934 | Ann Mei Lin | Hospitalist | 3643 N Roxboro St, Durham, NC 27704-2702 | 2019-08-31 |
| 1043868565 | Ashley Ann Mcgee | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2019-08-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1033625702 | Tondra A Little | Social Worker | 2804 Nellowood Street, Durham, NC 27704 | 2017-12-18 |
| 1437502408 | Jhazmere Shamas Preston | Counselor | 2609 N. Duke St. Suite 403, Durham, NC 27704 | 2016-07-14 |
| 1649626656 | Professional Elevations Pllc | Case Manager/Care Coordinator | 304 Crutchfield Drive, Durham, NC 27704 | 2016-05-09 |
| 1083071617 | Alyssa Wilson | Speech-Language Pathologist | 215 William Penn Plz Apt 908, Durham, NC 27704 | 2016-01-27 |
| 1932565124 | Arthur Reynolds Jr and Associates P.l.l.c. | Dentist | 2106 N Duke St, Durham, NC 27704 | 2016-01-05 |
| 1962877720 | Chimere Brooks | Contractor | 4001meriwether Drive Apt P-19, Durham, NC 27704 | 2015-12-04 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1730581901 | Images, 'of Me To You' | Community/Behavioral Health | 2823 Cascadilla Street, Durham, NC 27704 | 2014-09-19 |
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| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174170575 | Katherine Mccullough | Physician Assistant | Duke University Medicine Center 2301 Erwin Rd, Durham, NC 27710-0001 | 2019-08-20 |
| 1265947725 | Molly Cunningham Pradhan | Physician Assistant | 2301 Erwin Road Dumc 2945, Durham, NC 27710-0001 | 2017-12-06 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1821383878 | Justin Cain Anzalone | Physician Assistant | Duke University Medical Center Dumc 3704, Durham, NC 27710-0001 | 2011-06-16 |
| 1487960209 | Janelle Nichole Murphy | Physician Assistant | Duke Medicine - Duh, Dumc Box 3677, Durham, NC 27710 | 2010-08-31 |
| 1720224496 | Laura Geraghty | Physician Assistant | Dumc 3805, Durham, NC 27710-0001 | 2008-12-30 |
| 1225296825 | William Edward Cockfield | Physician Assistant | 2301 Erwin Rd Rm 7451h, Dumc 3174, Durham, NC 27710-3174 | 2008-05-30 |
| 1922155852 | Christopher John Vail | Physician Assistant | Duke University Hospital 2301 Erwin Rd, Medical Center North Box #3677, Durham, NC 27710-0001 | 2007-01-04 |
| 1164459665 | Kista Kidwell Hurley | Physician Assistant | 508 Fulton St # 112, Durham, NC 27705-3875 | 2006-06-28 |
| 1720048705 | Debra C Holmes | Physician Assistant | Dvamc Surg 112 A5004, 508 Fulton Street, Durham, NC 27705 | 2006-03-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.