Organization Active NPI

Dr. Thomas Cooke

  • Family Medicine Physician
  • Centralia, WA
National Provider Identifier
1194908368
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00000823 Issued in WA
Legal business name
DR. THOMAS COOKE
Practice address
1217 Mellen St
Centralia, WA 98531-1175
Phone
(360) 736-4021
Fax
(360) 736-3541
NPI assigned
Dec 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Authorized official

Name
Dr. Thomas R Cooke, D.O.
Title
Doctor
Phone
(360) 736-4021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OP00000823 WA Primary

Addresses

Primary practice location

1217 Mellen St
Centralia, WA 98531-1175

Mailing address

1217 Mellen St
Centralia, WA 98531-1175
Phone (360) 736-4021

Other identifiers 1

IdentifierTypeStateIssuer
7053861MedicaidWA

National Provider Directory

National Provider Directory

Locations

1217 Mellen St
Centralia, WA 98531
Phone (360) 330-2024

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1194908368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 MELLEN ST",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311175",
            "telephone_number": "360-736-4021",
            "fax_number": "360-736-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 MELLEN ST",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311175",
            "telephone_number": "360-736-4021",
            "fax_number": "360-736-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. THOMAS COOKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "COOKE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "360-736-4021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00000823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7053861",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.