Davita J Cook, MT

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1003588732 Issued in OH

Practice address

4572 Kapp Dr
Huber Heights, OH 45424-5921

Phone

(937) 250-9938

NPI assigned

Sep 30, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Medical Technician

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1003588732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4572 KAPP DR",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454245921",
            "telephone_number": "937-250-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4572 KAPP DR",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454245921",
            "telephone_number": "937-250-9938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "DAVITA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "OH",
            "license": "1003588732",
            "primary": false
        },
        {
            "code": "225500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "OH",
            "license": "1003588732",
            "primary": false
        },
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "NY",
            "license": "6009038",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "1003588732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0287258",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "1003588732",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "davitarapidtestinglaboratory@gmail.com",
            "affiliation": "Y",
            "affiliationName": "Topplez Corporation dba Davita Rapid Testing Laboratory",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4572 Kapp Dr",
            "city": "Huber Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454245921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Community Health Centers of Greater Dayton (First Flight Health Centers)
• Ashley Lynn Conley
• Marice A Conner
• Steven C Connett, O. D.
• Davida Cook
• Abigale Cooper, RBT
• Veronica Cope, OTR/L
• Joshua Copeland
• Christine Cox, PT
• Donna Lynn Cox, LPC LICENSED PROFESS

• Clinical Medical Laboratory in Huber Heights, OH
• Providers in Huber Heights, OH by specialty
• Clinical Medical Laboratory in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.