Jessica Danyel Cockerham · Physician Assistant

200 Hawthorne Ln, Charlotte, NC 28204-2515

Overview

Jessica Danyel Cockerham is a Physician Assistant practicing in Charlotte, North Carolina. The National Provider Identifier (NPI) is #1063727212, which was assigned on August 12, 2010, and the registration record was last updated on September 11, 2025. The practitioner's main practice location is at 200 Hawthorne Ln, Charlotte, NC 28204-2515; the contact telephone number is 7043849414. The primary taxonomy of Jessica Danyel Cockerham is Physician Assistant (363A00000X). Jessica Danyel Cockerham is licensed to practice in the state of North Carolina (#0010-02326).

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Provider Information

NPI 1063727212
Entity Type Individual
Provider Name JESSICA DANYEL COCKERHAM
Gender Female
Credential PA
Practice Address 200 Hawthorne Ln
Charlotte
NC 28204-2515
Practice Telephone 7043849414
Mailing Address Po Box 60447
Charlotte
NC 28260-0447
Certification Date 2025-09-11
Enumeration Date 2010-08-12
Last Update Date 2025-09-11
Is Sole Proprietor N

Doctor and Clinician Information

PAC ID 5092990531
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name JESSICA DANYEL COCKERHAM
Primary Specialty PHYSICIAN ASSISTANT
Organization Legal Name NOVANT HEALTH MEDICAL GROUP, LLC
Address 1901 Randolph Rd
Charlotte
NC 28207-1101

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y363A00000XPhysician Assistant0010-02326NC

Secondary Practice Locations

AddressTelephoneFax
1001 Blythe Blvd, Medical Center Plaza, Suite 200, Charlotte, NC 2820358667043818840
1350 S Kings Dr, Charlotte, NC 2820721347044461422
920 Church St N, Concord, NC 2802529277044033664

Taxonomy Information

Primary Taxonomy

Code 363A00000X
Taxonomy Physician Assistant
Classification Physician Assistant
Grouping Physician Assistants & Advanced Practice Nursing Providers
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

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Location Information

Street Address 200 HAWTHORNE LN
City CHARLOTTE
State NC
Zip Code 28204-2515
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Brittan Jobe 200 Hawthorne Ln, Charlotte, NC 28204-2515Neonatal Intensive Care Registered Nurse2024-10-29
Jerome Ellis Overton 200 Hawthorne Ln, Charlotte, NC 28204-2515Critical Care Medicine Registered Nurse2024-09-17
Lykeirra Steele 200 Hawthorne Ln, Charlotte, NC 28204-2515Physician Assistant2026-02-12
Trevor Lee Murray 200 Hawthorne Ln, Charlotte, NC 28204-2515Physician Assistant2025-06-13
The Presbyterian Hospital 200 Hawthorne Ln, Charlotte, NC 28204-2515Community/Retail Pharmacy2024-09-24
Jonathan Brockmeyer Mardis 200 Hawthorne Ln, Charlotte, NC 28204-2515Certified Registered Nurse Anesthetist2024-12-31
Lauren Mooneyhan Mccotter 200 Hawthorne Ln, Charlotte, NC 28204-2515Nurse Practitioner2025-07-05
Lauren Nicole Smith 200 Hawthorne Ln, Charlotte, NC 28204-2515Physician Assistant2025-06-11
Andrew Paul Edwards 200 Hawthorne Ln, Charlotte, NC 28204-2515Certified Registered Nurse Anesthetist2024-12-31
Ladonna Earwood 200 Hawthorne Ln, Charlotte, NC 28204-2515Psychiatric/Mental Health Nurse Practitioner2025-08-12
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Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Julie Sweet Rayner 200 Hawthorne Lane, Charlotte, NC 28204-2515Certified Registered Nurse Anesthetist2006-06-16
Dayna Leigh Slomba 200 Hawthorne Lane, Charlotte, NC 28204-2515Lactation Consultant (Non-RN)2013-03-27
Margaret Countiss Harbison 200 Hawthorne Lane, Charlotte, NC 28204-2515Mental Health Counselor2012-07-20
Cassie Steck 200 Hawthorne Lane, Charlotte, NC 28204-2515Physician Assistant2008-10-01

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Zi Yang Lin 1237 Harding Pl Ste 4200, Charlotte, NC 28204Acute Care Nurse Practitioner2021-06-30
Four Corners Testing LLC 301 S Mcdowell Street, Suite 125 - 1652, Charlotte, NC 28204Clinic/Center2023-01-20
Malia Suhren 360 North Caswell Road., Suite. 303, Charlotte, NC 28204Clinical Social Worker2023-06-30
Breanna Danielle Cobb 1300 Baxter St Suite 450, Charlotte, NC 28204Behavior Technician2025-10-13
Dana Lorraine Bjuro 205 S Kings Drive, Ste 150, Charlotte, NC 28204Family Nurse Practitioner2024-10-30
Keith Henry 301 S Mc Dowell Steets, Suite125-1572, Charlotte, NC 28204Military Health Care Provider2022-10-31
Amber Lilia Pellington 1237 Harding Pl, Ste 3100, Charlotte, NC 28204Acute Care Nurse Practitioner2018-07-31
Jesse Elijah Roberts 1801 E 5th Street, #208, Charlotte, NC 28204Mental Health Counselor2018-05-01
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Gopi Nilesh Patel 1237 Harding Place, Suite 3100, Charlotte, NC 28204Acute Care Nurse Practitioner2025-10-31
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.