Omar T Cockey, DMD,MPH

Primary specialty

DentistTaxonomy code 122300000X

License

DI 17684 Issued in NJ

Practice address

3010 Grand Ave
Waukegan, IL 60085-2321

Phone

(847) 377-8604

NPI assigned

Mar 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: omar.cockey.p1@direct.lakecountyil.nextgenshare.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.

• County of Lake

  dba Lake County Health Department and Community Health Center

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1013920750
  Medicare reassignment NPD
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • North Chicago, IL
  • NPI 1083643118
  NPD
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Round Lake, IL
  • NPI 1639588254
  NPD

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1154446318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "847-377-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "847-377-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKEY",
        "first_name": "OMAR",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DMD,MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI 17684",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.029675",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4608909",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerome Clark
• Julia Elizabeth Cleary
• Elena L Clements, RN
• Michelle C Clements, LPC
• Morgan Alexandria Cleveland
• Cognitive Pathways
• Elsa Elena Cohn
• Jennifer Colby
• Tracy Ann Cole-Russo, RN
• Justin Coleman

• Dentist in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.