Craig Allen Cooley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2391 Issued in KY

Practice address

1221 S Broadway
Lexington, KY 40504-2701

Phone

(859) 258-4000

NPI assigned

Aug 29, 2018

Sex

Male

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 KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Clark Emergency Physicians

  • Emergency Medicine Physician
  • Winchester, KY
  • NPI 1346781499
  Medicare reassignment
• Russell County Hospital

  • Certified Registered Nurse Anesthetist
  • Russell Springs, KY
  • NPI 1437245842
  Medicare reassignment
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382
  Medicare reassignment
• Russell County Hospital

  • Rural Health Clinic/Center
  • Russell Springs, KY
  • NPI 1295245025
  NPD
• Russell County Hospital

  • Specialist
  • Russell Springs, KY
  • NPI 1902079023
  NPD

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1346721164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200",
            "fax_number": "859-258-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 Dowell Rd",
            "address_purpose": "LOCATION",
            "city": "Russell Springs",
            "state": "KY",
            "postal_code": "426424579",
            "country_code": "US",
            "telephone_number": "270-866-4141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "CRAIG",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Jane Cooke, BSW
• Sarah Marie Cooke, CSW
• Cathie Cool, ARNP
• Trystannei Cool, CSW
• Andrew T Cooley, M.D.
• George Hutton Cooley
• Lisa L Cooley, LCSW, MSW, MA
• Merrick Heid Cooley, PA-S
• Jessica Lynnelle Coon
• Alyesse Jasmine Coonrod

• Physician Assistant in Lexington, KY
• Providers in Lexington, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.