Clint Cooksey, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Jena, LA
NPI 1205217064 · NPPES record last updated Jun 17, 2015
Key facts
- NPI
- 1205217064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP08337 (LA)
- Practice address
- 187 Ninth St
Jena, LA 71342-3900 - Phone
- (318) 992-9200
- NPI assigned
- Jun 17, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 20
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hospital Service District 2 of Lasalle Parish
Practice addresses (Care Compare)
187 9TH St
Jena, LA 71342-3900
Phone (318) 992-9200
Hospital & facility affiliations
- Lasalle Gen Hosp Home Health Agency
- Lasalle General Hospital
- Christus St Frances Cabrini Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160226001520 | LA | Practitioner - Nurse Practitioner | 9931404092 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Service District #2 of Lasalle Parish | Current |
Accepting new patients | |
| Hospital Service District #2 of Lasalle Parish | Past | Accepting new patients |
Locations
180 Ninth St
Jena, LA 71342
Phone (318) 992-6311
187 Ninth St
Jena, LA 71342
Phone (318) 992-9200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP08337 | LA | Yes |
Addresses
Primary practice location
187 Ninth St
Jena, LA 71342-3900
Mailing address
3721 Highway 459
Jena, LA 71342-6461
Phone (318) 312-0943
NPI Registry JSON
{
"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
- Christus Health Central Louisiana
- Charles D. Clauss
- Martin Eldridge Cloessner Jr.
- Aleisha Coleman
- Erica Cook
- Kristin Hailey Creed
- Walter P Creel
- Cross Country Medical Transport LLC
- Taren Danna
- Lisa Deville
All providers in Jena, LA · Family Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.