Deundra T Cooke, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

22322 Issued in SC

Practice address

102 Buford Ave
Anderson, SC 29621-3363

Phone

(864) 261-9506

NPI assigned

Oct 16, 2018

Last updated

Oct 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Upstate Wellness Center LLCGroup PAC ID 8527406545, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Upstate Wellness Center LLC

  • Psychiatry Physician
  • Anderson, SC
  • NPI 1871362459
  Medicare reassignment Care Compare group NPD
• Ernest C. Martin, M.D., P.a.

  • Psychiatry Physician
  • Anderson, SC
  • NPI 1871555896
  Medicare reassignment NPD

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1306312517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 RIVERBED DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296056425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 BUFORD AVE",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213363",
            "telephone_number": "864-261-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "DEUNDRA",
        "middle_name": "T",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "22322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne G Cook, MD
• Karla Lynn Cook, OTR-L
• Lisa H Cook
• Peter A Cook Jr., MD
• Rose M Cook, LPN
• Erin Cooksey Harrington, MD
• Peter B Coolidge, MD
• Kara Kristin Cooper-Gilmer, FNP
• Hampton Cooper, PHARMD
• Judith C Cooper, LPC

• Psychiatric/Mental Health Nurse Practitioner in Anderson, SC
• Providers in Anderson, SC by specialty
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.