Individual provider Active NPI

Amber Rose Cooksley, DPT

  • Physical Therapist
  • Dubuque, IA
National Provider Identifier
1285464289
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
125318 Issued in IA
Practice address
3080 N Cascade Rd
Dubuque, IA 52003-0301
Phone
(563) 231-9900
NPI assigned
Aug 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 125318 IA Primary

Addresses

Primary practice location

3080 N Cascade Rd
Dubuque, IA 52003-0301

Mailing address

1129 11TH St SE Ste a
Dyersville, IA 52040-2418
Phone (563) 875-8615

Other practice location 1

1129 11th St SE Ste A
Dyersville, IA 52040-2418
Phone (563) 875-8615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812003951 IA Practitioner - Physical Therapist in Private Practice 7618415464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jason J. Putz Physical Therapy P.C.Group PAC ID 2769578657, 18 clinicians

Practice addresses (Care Compare)

1129 11TH St SE a
Dyersville, IA 52040-2418
Phone (563) 875-8615

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jason J. Putz Physical Therapy P.C. CurrentSince Aug 5, 2024 Accepting new patients

Locations

245 Railroad Ave
Ste F2
Dubuque, IA 52003
Phone (563) 231-9900

1129 11th St SE
Ste A
Dyersville, IA 52040
Phone (563) 875-8615

107 S 11th St
Ste 1
Manchester, IA 52057
Phone (563) 927-1499

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1285464289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 11TH ST SE STE A",
            "city": "DYERSVILLE",
            "state": "IA",
            "postal_code": "520402418",
            "telephone_number": "563-875-8615",
            "fax_number": "563-875-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 N CASCADE RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520030301",
            "telephone_number": "563-231-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1129 11th St SE Ste A",
            "address_purpose": "LOCATION",
            "city": "Dyersville",
            "state": "IA",
            "postal_code": "520402418",
            "country_code": "US",
            "telephone_number": "563-875-8615",
            "fax_number": "563-875-8722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOKSLEY",
        "first_name": "AMBER",
        "middle_name": "ROSE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "125318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.