Individual provider Active NPI

Angel M Cook, FNP-BC

  • Family Nurse Practitioner
  • Union, KY
National Provider Identifier
1053177691
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4016628 Issued in KY
Practice address
2342 Antoinette Way
Union, KY 41091-7407
Phone
(513) 967-6159
NPI assigned
Feb 22, 2024
Last updated
Feb 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1132387 KY
Family Nurse Practitioner 363LF0000X 4016628 KY Primary

Addresses

Primary practice location

2342 Antoinette Way
Union, KY 41091-7407

Mailing address

2342 Antoinette Way
Union, KY 41091-7407
Phone (513) 967-6159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241011000186 KY Practitioner - Nurse Practitioner 0244762540 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1132387KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Farmers Branch, TX 75244
Phone (469) 466-7007

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1053177691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 ANTOINETTE WAY",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410917407",
            "telephone_number": "513-967-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2342 ANTOINETTE WAY",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410917407",
            "telephone_number": "513-967-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "ANGEL",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1132387",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4016628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, KY

Sources for this page

Verify at the official NPI Registry.