Individual provider Active NPI

Martha J Cook, PHD, CCC-SLP

  • Speech-Language Pathologist
  • Cape Girardeau, MO
National Provider Identifier
1174064406
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
02056 Issued in MO
Practice address
1 University PLZ
Ms 2600
Cape Girardeau, MO 63701-4710
Phone
(573) 651-2050
Fax
(573) 651-2827
NPI assigned
Mar 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 02056 MO Primary

Addresses

Primary practice location

1 University PLZ
Ms 2600
Cape Girardeau, MO 63701-4710

Mailing address

One University Plaza Ms 2600
Southeast Missouri State University
Cape Girardeau, MO 63701
Phone (573) 651-2050

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
02056MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1174064406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE UNIVERSITY PLAZA MS 2600",
            "address_2": "SOUTHEAST MISSOURI STATE UNIVERSITY",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "63701",
            "telephone_number": "573-651-2050",
            "fax_number": "573-651-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY PLZ",
            "address_2": "MS 2600",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014710",
            "telephone_number": "573-651-2050",
            "fax_number": "573-651-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "MARTHA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "02056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.