Individual provider Active NPI

Cynthia Ann Cooke, M.S.P.T.

  • Physical Therapist
  • Centralia, WA
National Provider Identifier
1306011903
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61436358 Issued in WA
Practice address
1714 S Gold St
Centralia, WA 98531-8951
Phone
(360) 360-5532
NPI assigned
Apr 24, 2008
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1136968 TX
Physical Therapist 225100000X PT61436358 WA Primary

Addresses

Primary practice location

1714 S Gold St
Centralia, WA 98531-8951

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

7812 Roberta Dr
Plano, TX 75025-2525
Phone (972) 322-7777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240614003248 WA Practitioner - Physical Therapist in Private Practice 3870036114 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1714 S Gold St
Centralia, WA 98531-8951
Phone (360) 360-5532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1136968TXMDPhysical Therapist
PT61436358WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Orthopaedic Center, Inc, PS CurrentSince Apr 20, 2024 Accepting new patients
Washington Orthopaedic Center, Inc., PS CurrentSince Apr 20, 2024 Accepting new patients
Northwest Center for Sports Medicine & Physical Therapy Inc Physical Therapist CurrentSince Nov 7, 2024 Accepting new patients
Peak Sports & Spine Physical Therapy-Klahanie PS Past Accepting new patients
Northwest Center for Sports Medicine & Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1714 S Gold St
Centralia, WA 98531
Phone (360) 360-5532

1900 Cooks Hill Rd
Centralia, WA 98531
Phone (360) 330-8627

4411 Point Fosdick Dr
Ste 101
Gig Harbor, WA 98335
Phone (253) 851-7472

4550 Klahanie Dr SE
Sammamish, WA 98029
Phone (425) 391-2427

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.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1306011903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 S GOLD ST",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985318951",
            "telephone_number": "360-360-5532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7812 Roberta Dr",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750252525",
            "country_code": "US",
            "telephone_number": "972-322-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOKE",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "credential": "M.S.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1136968",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61436358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.