KATHRYN OLSEN COCKERHAM, M.D. — NPI 1215100839 (Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) in ROOSEVELT, UT)

CMS-1500 Box 24J / 33a • NPI

1215100839

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

207P00000X (CMS 93)

Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)

Box 32 Service Location & ZIP+4

250 W 300 N, ROOSEVELT, UT, 84066-2336

✓ 9-Digit EDI 837 ZIP+4 (84066-2336)

Practice Phone & Referral Fax

(801) 722-4691

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1215100839 (KATHRYN OLSEN COCKERHAM, M.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1215100839` (NPI-1 Individual Practitioner)
Provider / Legal Name	KATHRYN OLSEN COCKERHAM, M.D.
Plain-English Specialty	Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) NUCC Code: `207P00000X` (Emergency Medicine)
Certifying / Licensing Body	American Board of Emergency Medicine (ABEM)
Practice Location Address	250 W 300 N, ROOSEVELT, UT, 84066-2336
Practice Telephone / Fax	Tel: (801) 722-4691
Administrative Mailing Address	250 W 300 N, ROOSEVELT, UT, 84066-2336
Enumeration & Last Sync	Enumerated: 2008-04-03 \| CMS Record Updated: 2025-12-09

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

250 W 300 N, ROOSEVELT, UT, 84066-2336

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Plain-English Taxonomy & CMS Crosswalk (207P00000X)

What Does Taxonomy Code 207P00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207P00000X translates to:
"Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 93 (Physician/Emergency Medicine)
Certifying / Accrediting Authority: American Board of Emergency Medicine (ABEM)
Clinical Scope: Immediate life-or-limb emergencies, severe chest pain, stroke symptoms, deep contaminated wounds needing tetanus prophylaxis, or severe dehydration.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KATHRYN OLSEN COCKERHAM, M.D.)

Typical CPT / Diagnostic Procedures:

Level 4 & Level 5 Emergency Department Resuscitation (CPT 99284–99285)
Point-of-Care Emergency Ultrasound (eFAST), Intubation & Central Line Placement
Acute Laceration Repair, Tetanus Prophylaxis & Fracture Splinting

Common Therapeutic Classes:

Epinephrine Auto-Injectors / IV Infusions, Atropine & Amiodarone
Tetanus Toxoid / Tdap & Tetanus Immunoglobulin (TIG)
Empiric Sepsis Antibiotics, Parenteral Ketorolac & Ondansetron

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207P00000X` — Emergency Medicine Plain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)	State: MT \| License: `MED-PHYS-LIC-33350` \| Primary: Secondary
`207P00000X` — Emergency Medicine Plain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)	State: UT \| License: `338161-1205` \| Primary: Yes (Primary)

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KATHRYN OLSEN COCKERHAM, M.D. (NPI #1215100839)