Jill Cooke

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL009202 Issued in PA

Practice address

6743 Fairway Dr E
Fayetteville, PA 17222-9400

Phone

(717) 360-3989

Fax

(717) 352-8360

NPI assigned

Jun 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jill Edge Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Childhood Early Intervention, LLC

  • Occupational Therapist
  • Fayetteville, PA
  • NPI 1336203843

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1083874994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 EQUESTRIAN DR",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172026803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6743 FAIRWAY DR E",
            "city": "FAYETTEVILLE",
            "state": "PA",
            "postal_code": "172229400",
            "telephone_number": "717-360-3989",
            "fax_number": "717-352-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "JILL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL009202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "EDGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kla J Brosius, CRNP
• Jonah Burke, DO
• Childhood Early Intervention, LLC
• Sandra M. Cifor, DO
• John Michael Connor, DO
• Sandra R Cooper, PTA
• Melissa Davis, CRNP
• Fayetteville Volunteer Fire Department
• Joan Marie Finui, PTA
• Amy Fleming, COTA/L

• Speech-Language Pathologist in Fayetteville, PA
• Providers in Fayetteville, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.