Active NPI
Amanda Cook, DO
- Pediatrics Physician
- Davis-Monthan Afb, AZ
National Provider Identifier
1073075099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- DO-05760
- Practice address
- 4175 S Alamo Ave
Davis-Monthan Afb, AZ 85707 - Phone
- (520) 228-2778
- NPI assigned
- Apr 1, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | DO-05760 | IA | Primary |
Addresses
Primary practice location
4175 S Alamo Ave
Davis-Monthan Afb, AZ 85707
Mailing address
4175 S Alamo Ave
Davis-Monthan Afb, AZ 85707
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO-05760 | IA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1073075099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4175 S ALAMO AVE",
"city": "DAVIS-MONTHAN AFB",
"state": "AZ",
"postal_code": "85707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4175 S ALAMO AVE",
"city": "DAVIS-MONTHAN AFB",
"state": "AZ",
"postal_code": "85707",
"telephone_number": "520-228-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "AMANDA",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-01",
"last_updated": "2022-08-02",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IA",
"license": "DO-05760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davis-Monthan Afb, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.