Kimberly P. Cockerham · Kimberly Peele · Neuro-ophthalmology Physician

3636 Camino Del Rio N Ste 200, San Diego, CA 92108-1702

Overview

Kimberly P. Cockerham is a Neuro-ophthalmology Physician practicing in San Diego, California. The National Provider Identifier (NPI) is #1366493629, which was assigned on May 12, 2006, and the registration record was last updated on November 6, 2025. The practitioner's main practice location is at 3636 Camino Del Rio N Ste 200, San Diego, CA 92108-1702; the contact telephone number is 6196553705. The primary taxonomy of Kimberly P. Cockerham is Neuro-ophthalmology Physician (207WX0109X), with specialization in Neuro-ophthalmology. Kimberly P. Cockerham is licensed to practice in the state of California (#G86885), California (#G86885).

A neuro-ophthalmologist is a subspecialist of ophthalmology. This physician evaluates, treats, and studies disorders of the eye, orbit and nervous system having to do with interactions of the visual motor and visual sensory systems with the central nervous system. Neuro-ophthalmologists manage patients with complex and severe neuro-ophthalmological disorders.

Provider Information

NPI 1366493629
Entity Type Individual
Provider Name DR. KIMBERLY P. COCKERHAM
Other Name KIMBERLY PEELE
(Other Name)
Gender Female
Credential MD
Practice Address 3636 Camino Del Rio N Ste 200
San Diego
CA 92108-1702
Practice Telephone 6196553705
Mailing Address Po Box 503148
San Diego
CA 92150-3148
Mailing Telephone 6508049270
Certification Date 2025-11-06
Enumeration Date 2006-05-12
Last Update Date 2025-11-06
Is Sole Proprietor N

Doctor and Clinician Information

PAC ID 3678460300
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name KIMBERLY PEELE COCKERHAM
Primary Specialty OPHTHALMOLOGY
Organization Legal Name ST LUKES AT THE VILLAGES PA
Address 1050 Old Camp Rd
Suite 230
The Villages
FL 32162-1762

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
N207W00000XOphthalmologyG86885CA
Y207WX0109XOphthalmologyNeuro-ophthalmologyG86885CA

Other Provider Identifiers

Other IdentifierIssuing StateIssuerIdentifier Type
00G868850CAMEDICAID

Secondary Practice Locations

AddressTelephoneFax
3969 4th Ave Ste 301, San Diego, CA 9210331656196553705
5525 Grossmont Center Dr Ste 602, LA Mesa, CA 9194230096198101275
5555 Grossmont Center Dr, LA Mesa, CA 9194230196196553705

Taxonomy Information

Primary Taxonomy

Code 207WX0109X
Taxonomy Neuro-ophthalmology Physician
Classification Ophthalmology
Specialization Neuro-ophthalmology
Grouping Allopathic & Osteopathic Physicians
Definition: A neuro-ophthalmologist is a subspecialist of ophthalmology. This physician evaluates, treats, and studies disorders of the eye, orbit and nervous system having to do with interactions of the visual motor and visual sensory systems with the central nervous system. Neuro-ophthalmologists manage patients with complex and severe neuro-ophthalmological disorders.
Notes: Source: American Academy of Ophthalmology, www.aao.org [7/1/2017: new]
Additional Resources: Association of University Professors of Ophthalmology, www.aupo.org.

Other Taxonomy

Code 207W00000X
Taxonomy Ophthalmology Physician
Classification Ophthalmology
Grouping Allopathic & Osteopathic Physicians
Definition: An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Vitaleyes, PLLC 7347 Powell Rd Ste B, Wildwood, FL 34785-4258Neuro-ophthalmology Physician2025-10-20
Manal Musbah Mohammad Milhem 200 Hawkins Dr, Iowa City, IA 52242-1009Neuro-ophthalmology Physician2026-05-01

Location Information

Street Address 3636 CAMINO DEL RIO N STE 200
City SAN DIEGO
State CA
Zip Code 92108-1702
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Cockerham Eye Consultants Professional Corporation 3636 Camino Del Rio N Ste 200, San Diego, CA 92108-1702Ophthalmology Physician2007-01-29

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Vista Community Hospice, Inc. 3636 Camino Del Rio N Ste 245, San Diego, CA 92108-1702Community Based Hospice Care Agency2020-10-28

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Kelly Harfouche 1640 Camino Del Rio N Suite 206, Room 119/120, San Diego, CA 92108Family Nurse Practitioner2025-05-16
Telecare Corporation 2085-95 Hotel Circle South, San Diego, CA 92108Mental Illness Community Based Residential Treatment Facility2025-04-23
Russell Jay Niland 1011 Camino Del Rio South, Suite 300, San Diego, CA 92108Peer Specialist2026-04-01
Jessica Brooke Rea 7580 Metropolitan Dr. Ste 200 #1099, San Diego, CA 92108Massage Therapist2025-02-06
Roger George Lee Davis III 1011 Camino Del Rio S Suite 300, San Diego, CA 92108Rehabilitation Practitioner2026-01-08
Milo Bivens 2820 Camino Del Rio South, 100, San Diego, CA 92108Behavior Technician2023-06-26
Kathleen Ann Kramm 1011 Camino Del Rio South, Suite 300, San Diego, CA 92108Peer Specialist2025-10-30
Candice Johnston · Cameron Johnston 3750 Camino Del Rio North, Suite 105, San Diego, CA 92108Mental Health Counselor2023-10-02
Stephanie Bateman 10425 Caminito Cuervo, Unit 226, San Diego, CA 92108Behavior Technician2023-03-22
Elsie Francis · Elsie Alva 1011 Camino Del Rio S 300, San Diego, CA 92108Student in an Organized Health Care Education/Training Program2025-09-02
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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.