Samuel J Cork, AGPCNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

95025931 Issued in CA

Practice address

10535 Hospital Way
Mather, CA 95655-4200

Phone

(916) 843-7000

NPI assigned

Jul 11, 2023

Last updated

Jul 11, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1205514940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 KORET WAY",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432218",
            "telephone_number": "415-476-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 HOSPITAL WAY",
            "city": "MATHER",
            "state": "CA",
            "postal_code": "956554200",
            "telephone_number": "916-843-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORK",
        "first_name": "SAMUEL",
        "middle_name": "J",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95025931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben Conover
• Carly Nicole Cook, MSW
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• Lisa Cooper, LCSW
• Suzanne O'Sullivan Cooper, LCSW
• Melani Diane Cornish, LVN
• Jessi Nicole Corral, LCSW
• County of Sacramento (Femoyer Mental Health Services)
• Thomas Michael Crouse, LCSW
• Krisha Pangilinan Cuasay

• Gerontology Nurse Practitioner in Mather, CA
• Providers in Mather, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.