CLAYTON DALE II COCKRELL (CRNP) – Family Medicine Physician, NPI 1457461790

CLAYTON DALE II COCKRELL (CRNP) is a healthcare provider. based in Hamilton, Alabama. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. 1-099596 (AL). The NPI Number for CLAYTON DALE II COCKRELL (CRNP) is 1457461790

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
CLAYTON DALE II COCKRELL (CRNP)
NPI
1457461790
Phone
(205) 921-5556
Address
2131 MILITARY ST S
Enumeration Date
30 August 2006
Last Update Date
11 April 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2059210521
Graduation Year
2005 (21 years ago)
PAC ID
9436241932
Group Practice PAC ID
1658282322
Professional Enrollment ID
I20180702003030
Address ID
AL355705005HA1336XSXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

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Provider Addresses for CLAYTON DALE II COCKRELL (CRNP)

  • Military Street South, Hamilton, Marion County, Alabama, United States

    HAMILTON, AL 355706651

    Phone: (205) 921-5556

    Fax: (205) 921-5595

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 27 Open Payments records for all available years, with a total value of $481.

Total Amount is formed as General ($481) + Research ($0) + Ownership ($0) = $481.

Last reported payment date: 2024-10-22 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($117).

Total Amount

$481

General + Research + Ownership

Payments

27

Total payment records

General Amount

$481

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-22

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-07-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180702003030INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35570)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658282322View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MS
Internal MedicineAL
Nurse PractitionerAL
-AL
Certified Registered Nurse Anesthetist (Crna)MS
Hospitalist, Internal Medicine, HospitalistFL
Family PracticeAL
Vascular Surgery, General SurgeryMS
Certified Registered Nurse Anesthetist (Crna)MS
H O S P I T A L I S TTN

Reviews

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Frequently asked questions

Can I use this page to confirm CLAYTON DALE II COCKRELL (CRNP)'s NPI?
Yes. CLAYTON DALE II COCKRELL (CRNP) is listed with NPI 1457461790 in the public NPI dataset.
Does CMS list CLAYTON DALE II COCKRELL (CRNP) as active?
Yes — CLAYTON DALE II COCKRELL (CRNP) is active in the NPI listing used on this page.
What is CLAYTON DALE II COCKRELL (CRNP)'s specialty?
The listing groups CLAYTON DALE II COCKRELL (CRNP) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is CLAYTON DALE II COCKRELL (CRNP) based?
CLAYTON DALE II COCKRELL (CRNP) is tied to Hamilton, Alabama in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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