Mary Katherine Craven Cooke, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1814 Westchester Dr Ste 101
High Point, NC 27262-7369

Phone

(336) 802-2105

NPI assigned

May 19, 2016

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

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcooke2755576@carolinashealthcaresystem.direct-ci.com

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.

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment NPD
• Wake Forest Health Network LLC

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1477785756
  Medicare reassignment
• Wake Forest Health Network LLC

  • Neurology Physician
  • Winston Salem, NC
  • NPI 1700918877
  NPD
• Wake Forest Health Network, LLC

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1053175299
  NPD
• Cornerstone Health Care LLC

  • Clinical Medical Laboratory
  • Conover, NC
  • NPI 1871159145
  NPD (past)
• Wake Forest Health Network LLC

  • Gastroenterology Physician
  • High Point, NC
  • NPI 1295850923
  NPD (past)

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1134576101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 TAYLOR RIDGE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065073",
            "telephone_number": "910-391-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 WESTCHESTER DR STE 101",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627369",
            "telephone_number": "336-802-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "MARY",
        "middle_name": "KATHERINE CRAVEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Contessa'S Home Care Agency LLC
• Continuum Care Services, Inc.
• Guy Reid Conway, PT
• Jonathan A Cook, FNP-C
• Chad A Cooke, LPC
• Stephanie Anne Cooke, LCMHCA
• Juliette Bates Cooper, PHARMD
• Sharia Shondale Cooper, LPN
• Darrell A. Cope, MD
• Linda Copeland, M.S.

• Physician Assistant in High Point, NC
• Providers in High Point, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.