Active NPI
Rebecca L Cook
- Phlebology Physician
- Red Oak, GA
National Provider Identifier
1013459429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebology Physician
- License
- X3L7G8L3
- Practice address
- 3435 Roosevelt Hwy
Ste. 713
Red Oak, GA 30272-2320 - Phone
- (404) 400-5996
- Fax
- (404) 609-2688
- NPI assigned
- Nov 16, 2016
- Last updated
- Aug 13, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebology Physician | 202K00000X | X3L7G8L3 | GA | Primary |
Addresses
Primary practice location
3435 Roosevelt Hwy
Ste. 713
Red Oak, GA 30272-2320
Mailing address
3312 Northside Dr Ste D215
Macon, GA 31210-2599
Phone (800) 416-8374
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X3L7G8L3 | GA | MD | Phlebology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628812800000",
"number": "1013459429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3312 NORTHSIDE DR STE D215",
"city": "MACON",
"state": "GA",
"postal_code": "312102599",
"telephone_number": "800-416-8374",
"fax_number": "770-769-1444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3435 ROOSEVELT HWY",
"address_2": "STE. 713",
"city": "RED OAK",
"state": "GA",
"postal_code": "302722320",
"telephone_number": "404-400-5996",
"fax_number": "404-609-2688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "REBECCA",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-16",
"last_updated": "2021-08-13",
"certification_date": "2021-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "202K00000X",
"taxonomy_group": "",
"desc": "Phlebology",
"state": "GA",
"license": "X3L7G8L3",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.