Individual provider Active NPI

Shirley Ann Cook, PT

  • Orthopedic Physical Therapist
  • Santa Rosa, CA
National Provider Identifier
1033343140
Registry record updated May 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT34445 Issued in CA
Practice address
1400 N Dutton Ave
Suite1
Santa Rosa, CA 95401-4657
Phone
(707) 523-2848
NPI assigned
May 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT34445 CA Primary

Addresses

Primary practice location

1400 N Dutton Ave
Suite1
Santa Rosa, CA 95401-4657

Mailing address

1400 N Dutton Ave
Suite1
Santa Rosa, CA 95401-4657
Phone (707) 523-2848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110113000359 CA Practitioner - Physical Therapist in Private Practice 6709075302 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Pleasant Hill Ave N
Sebastopol, CA 95472-3104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Focus Forward Wellness & Physical Therapy Orthopedic CurrentSince Apr 1, 2018 Accepting new patients
Santa Rosa Back Fitness and Physical Therapy Inc Orthopedic CurrentSince Sep 9, 2010 Accepting new patients
Sebastopol Physical Therapy and Pilates Studio Past Accepting new patients

Locations

2436 Foothill Blvd
Ste C
Calistoga, CA 94515
Phone (707) 942-3927

2798 Yulupa Ave
Ste 1
Santa Rosa, CA 95405
Phone (707) 527-4001

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241481600000",
    "number": "1033343140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N DUTTON AVE",
            "address_2": "SUITE1",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014657",
            "telephone_number": "707-523-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N DUTTON AVE",
            "address_2": "SUITE1",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014657",
            "telephone_number": "707-523-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "SHIRLEY",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT34445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.