Kyle A Cooke, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4960TG Issued in TX

Practice address

990 Hwy 287 N
Suite 109
Mansfield, TX 76063

Phone

(817) 453-4682

Fax

(817) 453-4353

NPI assigned

Nov 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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.

• Mansfield Vision Center LLC

  • Clinic/Center
  • Mansfield, TX
  • NPI 1407020985
  Authorized official Same address or phone

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265501332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 HWY 287 N",
            "address_2": "SUITE 109",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "76063",
            "telephone_number": "817-453-4682",
            "fax_number": "817-453-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 HWY 287 N",
            "address_2": "SUITE 109",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "76063",
            "telephone_number": "817-453-4682",
            "fax_number": "817-453-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "KYLE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4960TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conscious Freedom, LLC
• Conscious Health Wholeness (Methodist Mansfield Wound Care Center)
• Cook Children's Medical Center (Cook Children's Urgent Care Center Mansfield)
• Cook Children's Medical Center (Cook Children's Urgent Care Mansfield)
• Lori J Cook, LPC
• Morgan Copeland, PA-C
• Shawn M. Corwin, MD
• Nadia Ivelisse Costa-Lugo, M.S. CCC-SLP
• Costco Wholesale Corporation (Costco Optical #1793)
• Costco Wholesale Corporation (Costco Pharmacy #1793)

• Optometrist in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.