Carla N Cooke, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

003241 Issued in GA

Practice address

1805 Parke Plaza Cir
Suite 101
Stone Mountain, GA 30087-3637

Phone

(770) 469-7000

Fax

(770) 879-0436

NPI assigned

Feb 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: carlacooke@stonemount.allscriptsdirect.net

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.

• Qcpi-Villagemd, PC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1558872432
  Medicare reassignment

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

{
    "created_epoch": "1360540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1205175262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 PARKE PLAZA CIR",
            "address_2": "SUITE 101",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873637",
            "telephone_number": "770-469-7000",
            "fax_number": "770-879-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 PARKE PLAZA CIR",
            "address_2": "SUITE 101",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873637",
            "telephone_number": "770-469-7000",
            "fax_number": "770-879-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "CARLA",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-11",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Comprehensive Vine Health Services
• Theresa Comrie, RN
• Concoh Health Care
• Connection Bridge Oasis, Inc.
• Christopher Connelly, D.C.
• Carmen Cooper, MA
• Jeniesha Cooper, LPN
• Tanisha Chantal Cooper, PHARMD.
• Della Corbin-Johnson, RPH
• Edward A Corkran, D.O.

• Medical Physician Assistant in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.