Individual provider Active NPI

Jeffrey Scott Cook, DPT, OMPT

  • Physical Therapist
  • Grand Ledge, MI
National Provider Identifier
1295009199
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015822 Issued in MI
Practice address
615 S Clinton St
Grand Ledge, MI 48837-2355
Phone
(517) 709-4677
Fax
(517) 897-5667
NPI assigned
Feb 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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 5501015822 MI Primary

Addresses

Primary practice location

615 S Clinton St
Grand Ledge, MI 48837-2355

Mailing address

2380 Cedar St.
Suite 203
Holt, MI 48842
Phone (517) 709-4677

Other practice location 1

2380 Cedar St Ste 203
Holt, MI 48842-2211
Phone (517) 709-4677

Other practice location 2

3315 E Michigan Ave Ste 6
Lansing, MI 48912-4600
Phone (517) 709-4677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120803000194 MI Practitioner - Physical Therapist in Private Practice 1153577366 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Rehabilitation Physical Therapist CurrentSince May 4, 2015 Accepting new patients
Ryan and Monica Wohlfert, PC PastSince Nov 30, 2006 Accepting new patients

Locations

615 S Clinton St
Grand Ledge, MI 48837
Phone (517) 709-4677

2380 Cedar St
Ste 203
Holt, MI 48842
Phone (517) 709-4677

751 S Latson Rd
Apt C
Howell, MI 48843
Phone (517) 709-4677

3315 E Michigan Ave
Ste 6
Lansing, MI 48912
Phone (517) 709-4677

Organizations & group practices 2

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.

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Rehabilitation 19 clinicians

Practice addresses (Care Compare)

2380 Cedar St
Suite 203
Holt, MI 48842-2211
Phone (517) 709-4677

NPI Registry JSON

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1295009199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 CEDAR ST.",
            "address_2": "SUITE 203",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "48842",
            "telephone_number": "517-709-4677",
            "fax_number": "517-798-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S CLINTON ST",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488372355",
            "telephone_number": "517-709-4677",
            "fax_number": "517-897-5667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2380 Cedar St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Holt",
            "state": "MI",
            "postal_code": "488422211",
            "country_code": "US",
            "telephone_number": "517-709-4677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3315 E Michigan Ave Ste 6",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489124600",
            "country_code": "US",
            "telephone_number": "517-709-4677",
            "fax_number": "517-798-5667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "credential": "DPT, OMPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-24",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Ledge, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.