NPIMap

Individual provider Active NPI

Michael Thomas Cook, MD

  • Family Medicine Physician
  • Chehalis, WA
National Provider Identifier
1295397933
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61420065 Issued in WA
Practice address
4254 Jackson Hwy
Chehalis, WA 98532-8424
Phone
(360) 996-6603
Fax
(360) 996-6604
NPI assigned
Jul 2, 2019
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61420065 WA Primary

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 practice location 1

100 Cedar Crest Dr
Winlock, WA 98596-9791
Phone (360) 785-9400

Other identifiers 1

IdentifierTypeStateIssuer
2241987MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231201001459 WA Practitioner - Family Practice 7416371018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone (360) 330-9595

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Community Health Services Current Accepting new patients
Lewis County Community Health Services CurrentSince Dec 1, 2023 Accepting new patients
Lewis County Community Health Services CurrentSince Dec 1, 2023 Accepting new patients
Lewis County Community Health Services Past Accepting new patients
Lewis County Community Health Services Past Accepting new patients

Locations

2690 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 330-9595

4254 Jackson Hwy
Chehalis, WA 98532
Phone (360) 262-3966

100 Cedar Crest Dr
Winlock, WA 98596
Phone (360) 785-0300

Interoperability endpoints

  • Direct secure messaging: michael.cook.p1@direct.valleyviewhc.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1295397933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322412",
            "telephone_number": "360-330-9595",
            "fax_number": "360-330-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4254 JACKSON HWY",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985328424",
            "telephone_number": "360-996-6603",
            "fax_number": "360-996-6604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Cedar Crest Dr",
            "address_purpose": "LOCATION",
            "city": "Winlock",
            "state": "WA",
            "postal_code": "985969791",
            "country_code": "US",
            "telephone_number": "360-785-9400",
            "fax_number": "360-785-0236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61420065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2241987",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

Verify at the official NPI Registry.