M. Stacy Cook, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2870 95 Issued in MS

Legal business name

M. STACY COOK, DMD

Practice address

403 Main St
Leakesville, MS 39451

Phone

(601) 394-2467

Fax

(601) 394-2468

NPI assigned

May 22, 2007

Last updated

Apr 25, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Stacy Wilson

Title

Office Manager

Phone

(601) 394-2467

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Stacy Cook, D.M.D.

  • Dentist
  • Leakesville, MS
  • NPI 1801899620
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1073722203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "LEAKESVILLE",
            "state": "MS",
            "postal_code": "394510280",
            "telephone_number": "601-394-2467",
            "fax_number": "601-394-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 MAIN ST",
            "city": "LEAKESVILLE",
            "state": "MS",
            "postal_code": "39451",
            "telephone_number": "601-394-2467",
            "fax_number": "601-394-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. STACY COOK, DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-394-2467",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "2870 95",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AL",
            "identifier": "73003671",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MS",
            "identifier": "425495231B",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015334",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Johnson, PCMHT
• Bridget Keys, FNP
• Leakesville Rehabilitation and Nursing Center, Inc.
• Rodney Long
• Amy Malinda Lott, NURSE PRACTITIONER
• Charles A May, FNP
• Eric Ashley McCraney, CRNP
• Ashley McGown, PCCSS
• Franklin McGrew, PA-C
• Charity Mills, DPT

• Dentist in Leakesville, MS
• Providers in Leakesville, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.