Active NPI
Dora Jean Cooksey, LSW
- Social Worker
- Georgetown, OH
National Provider Identifier
1376724658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S-0029168
- Practice address
- 75 Banting Dr
Georgetown, OH 45121-1460 - Phone
- (937) 378-4811
- Fax
- (937) 378-4812
- NPI assigned
- Nov 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S-0029168 | OH | Primary |
Addresses
Primary practice location
75 Banting Dr
Georgetown, OH 45121-1460
Mailing address
75 Banting Dr
Georgetown, OH 45121-1460
Phone (937) 378-4811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MC060600 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S-0029168 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195516800000",
"number": "1376724658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 BANTING DR",
"city": "GEORGETOWN",
"state": "OH",
"postal_code": "451211460",
"telephone_number": "937-378-4811",
"fax_number": "937-378-4812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 BANTING DR",
"city": "GEORGETOWN",
"state": "OH",
"postal_code": "451211460",
"telephone_number": "937-378-4811",
"fax_number": "937-378-4812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOKSEY",
"first_name": "DORA JEAN",
"name_prefix": "Ms.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-15",
"last_updated": "2007-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S-0029168",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MC060600",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.