Individual provider Active NPI

Elizabeth Dollar Cooke, PTA

  • Physical Therapy Assistant
  • Round Rock, TX
National Provider Identifier
1396225017
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2120886 Issued in TX
Practice address
17751 Park Valley Dr
Round Rock, TX 78681-3592
Phone
(512) 218-6013
NPI assigned
Aug 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2120886 TX Primary

Addresses

Primary practice location

17751 Park Valley Dr
Round Rock, TX 78681-3592

Mailing address

2624 Lou John St
Austin, TX 78727-1243
Phone (512) 923-5450

Other identifiers 1

IdentifierTypeStateIssuer
2120886OtherTXTEXAS BOARD OF PHYSICAL THERAPY EXAMINERS

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

LicenseStateTypeSpecialty
2120886TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1396225017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 LOU JOHN ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787271243",
            "telephone_number": "512-923-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17751 PARK VALLEY DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786813592",
            "telephone_number": "512-218-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "ELIZABETH",
        "middle_name": "DOLLAR",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2120886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PHYSICAL THERAPY EXAMINERS",
            "identifier": "2120886",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.