Individual provider Active NPI

Clarissa Cook

  • Phlebotomy Technician
  • Warren, MI
National Provider Identifier
1194391391
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
W5C4F8R8 Issued in MI
Practice address
7284 Continental Ave
Warren, MI 48091-3532
Phone
(586) 217-1494
Fax
(586) 980-6933
NPI assigned
May 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X W5C4F8R8 MI Primary

Addresses

Primary practice location

7284 Continental Ave
Warren, MI 48091-3532

Mailing address

7284 Continental Ave
Warren, MI 48091-3532
Phone (586) 217-1494

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

State licenses

LicenseStateTypeSpecialty
W5C4F8R8MIMDPhlebotomy Technician

NPI Registry JSON

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1194391391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7284 CONTINENTAL AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480913532",
            "telephone_number": "586-217-1494",
            "fax_number": "586-980-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7284 CONTINENTAL AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480913532",
            "telephone_number": "586-217-1494",
            "fax_number": "586-980-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "CLARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "MI",
            "license": "W5C4F8R8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.