Thomas R Cooke, D.O.
Individual provider Active NPI General Practice Physician · Chehalis, WA
NPI 1255427902 · NPPES record last updated Feb 8, 2024
Key facts
- NPI
- 1255427902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- OP00000823 (WA)
- Practice address
- 4254 Jackson Hwy
Chehalis, WA 98532-8424 - Phone
- (360) 996-6603
- Fax
- (360) 996-6604
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lewis County Community Health Services
Practice addresses (Care Compare)
117 Ramsey Way
Valley View Toledo
Toledo, WA 98591-9900
Phone (360) 864-4400
4254 Jackson Hwy
Chehalis, WA 98532-8424
Phone (360) 729-0160
Hospital & facility affiliations
- Providence Centralia Hospital
- Peacehealth St John Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090130000336 | WA | Practitioner - General Practice | 3375607609 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP00000823 | WA | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lewis County Community Health Services | Current | Accepting new patients | |
| Lewis County Community Health Services | Current |
Accepting new patients | |
| Lewis County Community Health Services | Current |
Accepting new patients | |
| Lewis County Community Health Services | Past | Accepting new patients |
Locations
4254 Jackson Hwy
Chehalis, WA 98532
Phone (360) 262-3966
2690 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 330-9595
Interoperability endpoints
- thomas.cookedo.p1@direct.valleyviewhc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | OP00000823 | WA | Yes |
| Family Medicine Physician | 207Q00000X | OP00000823 | WA |
Addresses
Primary practice location
4254 Jackson Hwy
Chehalis, WA 98532-8424
Mailing address
2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone (360) 330-9595
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2182956 | Medicaid | WA |
Other providers in Chehalis, WA
- Tamara Annette Cole
- Community Allied Behavioral Health
- Zachary Cameron Condon
- Ariel Marie Cook
- Michael Thomas Cook
- Amanda Michelle Cordero
- Amber Lynn Corneal
- Lisa Cornell
- Ekaterine Cosser
- Travis J Cothren
All providers in Chehalis, WA · General Practice Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2024. 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.