Jason T. Cook, PSY.D., HSPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20041587A Issued in IN

Practice address

7230 Engle Rd
Ste 304
Fort Wayne, IN 46804-2209

Phone

(260) 483-2400

Fax

(260) 960-9361

NPI assigned

Feb 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cook Behavioral Health Clinic PCGroup PAC ID 3274584487, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cook Behavioral Health Clinic, PC

  • Psychologist
  • Fort Wayne, IN
  • NPI 1265691257
  Medicare reassignment Care Compare group Authorized official
• Park Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1306897004
  Medicare reassignment NPD
• Park Center Inc

  • Psychiatric Hospital
  • Fort Wayne, IN
  • NPI 1457772402
  NPD

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1043283641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7230 ENGLE RD",
            "address_2": "STE 304",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042209",
            "telephone_number": "260-481-2700",
            "fax_number": "260-481-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7230 ENGLE RD",
            "address_2": "STE 304",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042209",
            "telephone_number": "260-483-2400",
            "fax_number": "260-960-9361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "JASON",
        "middle_name": "T.",
        "credential": "PSY.D., HSPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041587A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200290630",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Cook-Johnson
• Cortney Shean Cook
• Dina L Cook, LCSW
• Emily H Cook, LMHCA
• Ian H. Cook, M.D.
• Jennifer Lynn Cook
• Katie Cook
• Kevin R Cook, RPH
• Margaret Ann Cook, MSW, LCSW
• Meghan Jo Cook, AGPCNP-BC

• Clinical Psychologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.