Active NPI
Jennifer Kooker
- Clinical Social Worker
- Albemarle, NC
National Provider Identifier
1174648547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C005902
- Practice address
- 350 Pee Dee Ave
Albemarle, NC 28001-4900 - Phone
- (704) 986-1500
- Fax
- (704) 983-3919
- NPI assigned
- Mar 21, 2007
- Last updated
- Jan 22, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 043544 | NY | |
| Clinical Social Worker | 1041C0700X | C005902 | NC | Primary |
Addresses
Primary practice location
350 Pee Dee Ave
Albemarle, NC 28001-4900
Mailing address
350 Pee Dee Ave
Albemarle, NC 28001-4900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6007161 | Medicaid | NC |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232582400000",
"number": "1174648547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 PEE DEE AVE",
"city": "ALBEMARLE",
"state": "NC",
"postal_code": "280014900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 PEE DEE AVE",
"city": "ALBEMARLE",
"state": "NC",
"postal_code": "280014900",
"telephone_number": "704-986-1500",
"fax_number": "704-983-3919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOOKER",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2009-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "043544",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C005902",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6007161",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albemarle, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.