NPI 1215100839 · live from the CMS NPI Registry
Kathryn Olsen Cockerham, M.D.
Emergency Medicine in Roosevelt, UT. National Provider Identifier 1215100839, active.
NPI record
| NPI | 1215100839 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Emergency Medicine 207P00000X |
| Practice location | 250 W 300 N, Roosevelt, UT 84066 |
| Practice phone | 801-722-4691 |
| Enumerated | April 3, 2008 |
| Last updated | December 9, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emergency Medicine | 207P00000X | MED-PHYS-LIC-33350 (MT) |
| Emergency Medicine primary | 207P00000X | 338161-1205 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.