Active NPI
Sandra Lee Cook, CNM
- Advanced Practice Midwife
- Kotzebue, AK
National Provider Identifier
1124219191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 612
- Practice address
- 436 & 5TH Street Ted Stevens Way
Maniilaq Health Center
Kotzebue, AK 99752 - Phone
- (541) 604-5097
- NPI assigned
- Aug 6, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 612 | AK | Primary |
| Advanced Practice Midwife | 367A00000X | 086C03015N5 | OR |
Addresses
Primary practice location
436 & 5TH Street Ted Stevens Way
Maniilaq Health Center
Kotzebue, AK 99752
Mailing address
10275 SW Shamrock LN
Culver, OR 97734
Phone (541) 604-5097
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)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 086C03015N5 | OR | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331251200000",
"number": "1124219191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10275 SW SHAMROCK LN",
"city": "CULVER",
"state": "OR",
"postal_code": "97734",
"telephone_number": "541-604-5097",
"fax_number": "484-842-2117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "436 & 5TH STREET TED STEVENS WAY",
"address_2": "MANIILAQ HEALTH CENTER",
"city": "KOTZEBUE",
"state": "AK",
"postal_code": "99752",
"telephone_number": "541-604-5097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "SANDRA",
"middle_name": "LEE",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-06",
"last_updated": "2012-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "AK",
"license": "612",
"primary": true
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "OR",
"license": "086C03015N5",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kotzebue, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.