Individual provider Active NPI

Marisa Lynn Cook, OTR/L

  • Occupational Therapist
  • Lake Park, FL
National Provider Identifier
1154550291
Registry record updated Jan 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT12007 Issued in FL
Practice address
804 US Highway 1 Ste 8
Lake Park, FL 33403-2940
Phone
(561) 429-6018
NPI assigned
Jul 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT12007 FL Primary

Addresses

Primary practice location

804 US Highway 1 Ste 8
Lake Park, FL 33403-2940

Mailing address

253 E Kalmia Dr
Lake Park, FL 33403-2718
Phone (772) 631-8216

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

State licenses

LicenseStateTypeSpecialty
OT12007FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet Florida Physician Services II, LLC CurrentSince May 6, 2019 Accepting new patients
Anchor OT, LLC Occupational Therapist CurrentSince Jan 26, 2022 Accepting new patients
Tenet Florida Physician Services II, LLC CurrentSince May 6, 2019 Accepting new patients

Locations

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642291200000",
    "number": "1154550291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 E KALMIA DR",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334032718",
            "telephone_number": "772-631-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 US HIGHWAY 1 STE 8",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334032940",
            "telephone_number": "561-429-6018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "MARISA",
        "middle_name": "LYNN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2022-01-16",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT12007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.