Tabitha Martina Cook, LICENSED OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

1213 Issued in SC

Practice address

4875 Old York Rd
Rock Hill, SC 29732-8127

Phone

(803) 323-2097

Fax

(803) 980-0076

NPI assigned

Jun 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Tabitha Martina Cook Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1104556406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4875 OLD YORK RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297328127",
            "telephone_number": "803-323-2097",
            "fax_number": "803-980-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 OLD YORK RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297328127",
            "telephone_number": "803-323-2097",
            "fax_number": "803-980-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "TABITHA",
        "middle_name": "MARTINA",
        "name_prefix": "Mrs.",
        "credential": "LICENSED OPTICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "SC",
            "license": "1213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TABITHA",
            "last_name": "COOK",
            "middle_name": "MARTINA",
            "prefix": "MRS.",
            "credential": "LICENSED OPTICIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shane Tyler Conway, DPT
• John Cook
• Ketara Cook
• Lindsay Fincher Cook, MSN, APRN, FNP-BC
• Mary Amanda Cook, CPHT
• Tara D Cook, LMBT, LCNT
• Coombs Family Orthodontics
• Paul S. Coombs Jr., DMD
• Spencer Coombs, D.M.D.
• Christian Brooke Cooper, M.ED., LPC-A

• Optician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Optician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.

Verify at the official NPI Registry.