Active NPI
Carrie R. Cook, PT
- Geriatric Physical Therapist
- Golden, IL
National Provider Identifier
1457546277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 070004200
- Practice address
- 101 Prairie Mills Rd
Golden, IL 62339-1016 - Phone
- (217) 696-4421
- Fax
- (217) 696-4393
- NPI assigned
- Sep 14, 2007
- Last updated
- Sep 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 070004200 | IL | Primary |
Addresses
Primary practice location
101 Prairie Mills Rd
Golden, IL 62339-1016
Mailing address
2834 N 2200TH Ave
Clayton, IL 62324-2312
Phone (217) 696-4881
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070004200 | IL | MD | Geriatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caremark Rehab, LTD. | Geriatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189814400000",
"number": "1457546277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2834 N 2200TH AVE",
"city": "CLAYTON",
"state": "IL",
"postal_code": "623242312",
"telephone_number": "217-696-4881",
"fax_number": "217-696-4881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 PRAIRIE MILLS RD",
"city": "GOLDEN",
"state": "IL",
"postal_code": "623391016",
"telephone_number": "217-696-4421",
"fax_number": "217-696-4393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "CARRIE",
"middle_name": "R.",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-14",
"last_updated": "2007-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "IL",
"license": "070004200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Golden, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.