Organization Active NPI

Cynthia L Cookingham MD PC

  • Allergy & Immunology Physician
  • Clarkston, MI
National Provider Identifier
1326101304
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
CC048327 Issued in MI
Legal business name
CYNTHIA L COOKINGHAM MD PC
Practice address
5885 S Main Street
Suite #1
Clarkston, MI 48346
Phone
(248) 620-1900
Fax
(248) 620-1904
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Cynthia L CookinghamNPI 1295891935
Title
MD
Phone
(248) 620-1900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X CC048327 MI Primary

Addresses

Primary practice location

5885 S Main Street
Suite #1
Clarkston, MI 48346

Mailing address

5885 S Main Street
Suite #1
Clarkston, MI 48346
Phone (248) 620-1900

Other identifiers 1

IdentifierTypeStateIssuer
4322960MedicaidMI

Other names 1

  • Clarkston Allergy and Asthma Clinic PC Doing business as

National Provider Directory

National Provider Directory

Locations

5885 S Main St
Ste 1
Clarkston, MI 48346
Phone (248) 620-1900

1691 E US 23
Ste 5
East Tawas, MI 48730
Phone (888) 477-1900

295 Maple St
Tawas City, MI 48763
Phone (517) 362-8591

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326101304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5885 S MAIN STREET",
            "address_2": "SUITE #1",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-620-1900",
            "fax_number": "248-620-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5885 S MAIN STREET",
            "address_2": "SUITE #1",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-620-1900",
            "fax_number": "248-620-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYNTHIA L COOKINGHAM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COOKINGHAM",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "248-620-1900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "CC048327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4322960",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarkston Allergy and Asthma Clinic PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.