Individual provider Active NPI

Clint Cooksey, FNP-C

  • Family Nurse Practitioner
  • Jena, LA
National Provider Identifier
1205217064
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP08337 Issued in LA
Practice address
187 Ninth St
Jena, LA 71342-3900
Phone
(318) 992-9200
NPI assigned
Jun 17, 2015
Last updated
Jun 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP08337 LA Primary

Addresses

Primary practice location

187 Ninth St
Jena, LA 71342-3900

Mailing address

3721 Highway 459
Jena, LA 71342-6461
Phone (318) 312-0943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160226001520 LA Practitioner - Nurse Practitioner 9931404092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

187 9TH St
Jena, LA 71342-3900
Phone (318) 992-9200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP08337LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Service District #2 of Lasalle Parish CurrentSince Aug 20, 2019 Accepting new patients

Locations

180 Ninth St
Jena, LA 71342
Phone (318) 992-6311

187 Ninth St
Jena, LA 71342
Phone (318) 992-9200

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1205217064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 HIGHWAY 459",
            "city": "JENA",
            "state": "LA",
            "postal_code": "713426461",
            "telephone_number": "318-312-0943",
            "fax_number": "318-992-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 NINTH ST",
            "city": "JENA",
            "state": "LA",
            "postal_code": "713423900",
            "telephone_number": "318-992-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKSEY",
        "first_name": "CLINT",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jena, LA

Sources for this page

Verify at the official NPI Registry.