Individual provider Active NPI

Antranette Cooks, APRN

  • Family Nurse Practitioner
  • Palm Bay, FL
National Provider Identifier
1104523000
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11024510 Issued in FL
Practice address
490 Centre Lake Dr NE Ste 200
Palm Bay, FL 32907-1189
Phone
(321) 821-4950
Fax
(321) 821-4955
NPI assigned
Feb 10, 2023
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X APRN11024510 FL
Family Nurse Practitioner 363LF0000X 11024510 FL Primary

Addresses

Primary practice location

490 Centre Lake Dr NE Ste 200
Palm Bay, FL 32907-1189

Mailing address

1005 Bowsprit Ave NW
Palm Bay, FL 32907-9485
Phone (321) 501-6125

Other practice location 1

1005 Bowsprit Ave NW
Palm Bay, FL 32907-9485
Phone (321) 501-6125

Other identifiers 1

IdentifierTypeStateIssuer
202248493MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230427000166 FL Practitioner - Nurse Practitioner 2466817499 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Two Rivers Family Practice PLLCGroup PAC ID 7810023421, 7 clinicians

Practice addresses (Care Compare)

1231 S Patrick Dr
Satellite Beach, FL 32937-3956
Phone (321) 622-5432

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11024510FLMDPain Medicine Physician
11024510FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medfast Urgent Care Centers, LLC CurrentSince Jun 1, 2023 Accepting new patients
Medfast Urgent Care Centers LLC Current Accepting new patients
Medfast Urgent Care Centers, LLC CurrentSince Jun 1, 2023 Accepting new patients
Two Rivers Family Practice PLLC CurrentSince May 27, 2025 Accepting new patients
Aaron J West MD PA CurrentSince Apr 1, 2023 Accepting new patients

Locations

5011 Gate Pkwy
Bldg 100
Jacksonville, FL 32256
Phone (904) 512-7239

5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627

490 Centre Lake Dr NE
Ste 200
Palm Bay, FL 32907
Phone (321) 821-4950

5005 Port St John Pkwy
Port St John, FL 32927
Phone (321) 504-0556

1231 South Patrick Dr
Satellite Beach, FL 32937
Phone (321) 622-5432

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: antranette.cooks@989632778731524.direct.elationemr.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1104523000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BOWSPRIT AVE NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329079485",
            "telephone_number": "321-501-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 CENTRE LAKE DR NE STE 200",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071189",
            "telephone_number": "321-821-4950",
            "fax_number": "321-821-4955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Bowsprit Ave NW",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329079485",
            "country_code": "US",
            "telephone_number": "321-501-6125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOKS",
        "first_name": "ANTRANETTE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "APRN11024510",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11024510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202248493",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.