Active NPI
Shasta Tobi Cooke
- Behavior Analyst
- Eugene, OR
National Provider Identifier
1447740527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 677 1/2 W 12TH Ave
Eugene, OR 97402 - Phone
- (530) 356-0655
- NPI assigned
- May 15, 2018
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
677 1/2 W 12TH Ave
Eugene, OR 97402
Mailing address
677 Half W 12TH Ave
Eugene, OR 97402
Phone (530) 356-0655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y3753896 | Other | CA | GOV |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526342400000",
"number": "1447740527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "677 HALF W 12TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "97402",
"telephone_number": "530-356-0655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "677 1/2 W 12TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "97402",
"telephone_number": "530-356-0655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOKE",
"first_name": "SHASTA",
"middle_name": "TOBI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-15",
"last_updated": "2018-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GOV",
"identifier": "Y3753896",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.