Cullen Conrad Cooke, MA, CFY-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202008324 Issued in VA

Practice address

625 Piney Forest Rd Ste 407
Danville, VA 24540-2870

Phone

(434) 799-7732

NPI assigned

Aug 21, 2016

Last updated

Aug 21, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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 VA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Speech and Occupational Therapy SpecialistsGroup PAC ID 4981034477, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Speech & Occupational Therapy Specialists

  • Multi-Specialty Clinic/Center
  • Danville, VA
  • NPI 1902437841

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1471737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471737600000",
    "number": "1366997298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 MOUNT VERNON AVE",
            "address_2": "APT A",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245412815",
            "telephone_number": "803-646-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 PINEY FOREST RD STE 407",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245402870",
            "telephone_number": "434-799-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "CULLEN",
        "middle_name": "CONRAD",
        "name_prefix": "Mr.",
        "credential": "MA, CFY-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-21",
        "last_updated": "2016-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bryan Mark Conder, DO
• Melinda G. Conley, LCSW
• Christina H Cook
• Donald C Cooper, DDS
• Cathy S Coppernoll, L.M.T.
• Coremedx Inc.
• Lauren Elizabeth Cornell, MS, CF-SLP
• Cornerstone Behavioral Health Services Inc

• Speech-Language Pathologist in Danville, VA
• Providers in Danville, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2016; 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.