Individual provider Active NPI

Tiffany Cooke, M.D.

  • Psychiatry Physician
  • Danville, PA
National Provider Identifier
1386853547
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD469691 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-1458
Phone
(570) 271-6516
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 62489 GA
Psychiatry Physician 2084P0800X MD469691 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-1458

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110829000092 GA Practitioner - Psychiatry 8224208301 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD469691PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
View Point Health CurrentSince Aug 4, 2011 Accepting new patients
Morehouse Healthcare, Inc. Psychiatry CurrentSince Jul 1, 2013 Accepting new patients
The Southeast Permanente Medical Group Psychiatry CurrentSince Jul 2, 2018 Accepting new patients
Premier Healthcare Investments CurrentSince Dec 1, 2017 Accepting new patients
Premier Healthcare Investments CurrentSince Dec 1, 2017 Accepting new patients
Tanner Medical Group Inc Psychiatry PastSince Feb 1, 2016 Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

720 Westview Dr SW
Atlanta, GA 30310
Phone (404) 756-1383

75 Piedmont Ave NE
Ste 700
Atlanta, GA 30303
Phone (404) 756-1410

1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086

175 Gwinnett Dr
Lawrenceville, GA 30046
Phone (678) 209-2394

509 Sumter St
Montezuma, GA 31063
Phone (478) 472-2321

200 Crescent Center Pkwy
Tucker, GA 30084
Phone (770) 496-3609

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1386853547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178221458",
            "telephone_number": "570-271-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "TIFFANY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "62489",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD469691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.