Active NPI
Jay Mark Cool, P.A.
- Medical Physician Assistant
- Campo, CA
National Provider Identifier
1407887227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- MA001083L
- Practice address
- 31115 Highway 94
Campo, CA 91906 - Phone
- (619) 445-6200
- NPI assigned
- Jul 6, 2006
- Last updated
- Jul 12, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA001083L | PA | Primary |
Addresses
Primary practice location
31115 Highway 94
Campo, CA 91906
Mailing address
807 E Main St
Apt 6110
Durham, NC 27701-4077
Phone (814) 266-8696
Other practice location 1
29 Scalp Ave
Johnstown, PA 15904
Phone (814) 266-8696 ext. 5025
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53135 | CA | MD | Marriage & Family Therapist |
| MA001083L | PA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1407887227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 E MAIN ST",
"address_2": "APT 6110",
"city": "DURHAM",
"state": "NC",
"postal_code": "277014077",
"telephone_number": "814-266-8696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31115 HIGHWAY 94",
"city": "CAMPO",
"state": "CA",
"postal_code": "91906",
"telephone_number": "619-445-6200"
}
],
"practiceLocations": [
{
"address_1": "29 Scalp Ave",
"address_purpose": "LOCATION",
"city": "Johnstown",
"state": "PA",
"postal_code": "15904",
"country_code": "US",
"telephone_number": "814-266-8696 x5025",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COOL",
"first_name": "JAY",
"middle_name": "MARK",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA001083L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Campo, CA
- Centro de Salud de la Comunidad de San Ysidro, Inc. (San Ysidro Health Mountain Health Family Medicine)
- Centro de Salud de la Comunidad de San Ysidro, Inc. (San Ysidro Health Mobile Health Services 1K)
- Natalie Chavez, RADT
- Roy Colbourne, RADT
- Lucas Anthony Cook, RADT
- Carmen Correa, RADT
- Jodene Cuero, LMFT 102333
- Justin Davis, RADT
- John Francis De Hamm, CADC-CAS
- Michael George Dehamm, CADC II, ICADC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.