Active NPI
Karen Marie Cook, FNP
- Family Nurse Practitioner
- Pendleton, OR
National Provider Identifier
1164536546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R43012
- Practice address
- 73265 Confederated Way
Pendleton, OR 97801-0160 - Phone
- (541) 215-1965
- Fax
- (541) 278-7572
- NPI assigned
- Aug 19, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R43012 | NM | Primary |
Addresses
Primary practice location
73265 Confederated Way
Pendleton, OR 97801-0160
Mailing address
73265 Confederated Way
Pendleton, OR 97801-0160
Phone (541) 215-1965
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 621723 | Medicaid | AZ | |
| 53837525 | Medicaid | CO | |
| 171037 | Medicaid | OR | |
| 85134261 | Medicaid | NM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R43012 | NM | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Assured Imaging Womens Wellness of Washington, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Tukwila, WA
- NPI 1588982060
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333584000000",
"number": "1164536546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "73265 CONFEDERATED WAY",
"city": "PENDLETON",
"state": "OR",
"postal_code": "978010160",
"telephone_number": "541-215-1965",
"fax_number": "541-278-7572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "73265 CONFEDERATED WAY",
"city": "PENDLETON",
"state": "OR",
"postal_code": "978010160",
"telephone_number": "541-215-1965",
"fax_number": "541-278-7572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "KAREN",
"middle_name": "MARIE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2012-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NM",
"license": "R43012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "621723",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "53837525",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "171037",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "85134261",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pendleton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.