{
"Npi": {
"NPI": "1417593591",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "COCHRAN",
"FirstName": "ZACHARY",
"MiddleName": "TYLER",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "NP-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 12938",
"SecondLineMailingAddress": "C/O CLINIC MANAGEMENT",
"MailingAddressCityName": "CALHOUN",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30703-7013",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "706-602-7800",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "101 YELLOW JACKET DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CALHOUN",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30701-2407",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "706-879-6405",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/23/2019",
"LastUpdateDate": "10/21/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "APRN-NP231597",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}