Individual provider Active NPI

Jody Ann Cousins, MD

  • Family Medicine Physician
  • Anacortes, WA
National Provider Identifier
1467578799
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0086550 Issued in MD
Practice address
1213 24TH Street
Suite #100
Anacortes, WA 98221-2559
Phone
(360) 293-4655
Fax
(360) 588-1041
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7939A WY
Family Medicine Physician 207Q00000X MD046860 DC
Surgery Physician 208600000X 57012332 OH
Family Medicine Physician 207Q00000X D0086550 MD Primary
Family Medicine Physician 207Q00000X MD60132209 WA

Addresses

Primary practice location

1213 24TH Street
Suite #100
Anacortes, WA 98221-2559

Mailing address

6020 Richmond Hwy
Ste 102
Alexandria, VA 22303-2157
Phone (443) 393-3653

Other identifiers 1

IdentifierTypeStateIssuer
2007259MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20210414002548 WY Practitioner - Family Practice 1254456700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of WyomingGroup PAC ID 4183607054, 40 clinicians

Practice addresses (Care Compare)

820 E 17TH St
Cheyenne, WY 82001-4714
Phone (307) 431-5055

Hospital & facility affiliations

  • Cheyenne Regional Medical Center Hospital, Cheyenne, WY, CCN 530014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0086550MDMDFamily Medicine Physician
MD60132209WAMDFamily Medicine Physician
7939AWYMDFamily Medicine Physician
57012332OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wyoming Family Medicine CurrentSince Apr 1, 2021 Accepting new patients
University of Wyoming Speech and Hearing Clinic CurrentSince Apr 1, 2021 Accepting new patients
University of Wyoming Family Medicine Current Accepting new patients
University of Wyoming Family Medicine Past Accepting new patients
Memorial Hospital of Laramie County Past Accepting new patients

Locations

820 E 17th St
Cheyenne, WY 82001
Phone (307) 431-5055

2710 Harney St
Ste 202
Laramie, WY 82072
Phone (307) 742-3242

Interoperability endpoints

  • Direct secure messaging: jody.cousins.1@30244.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1467578799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 RICHMOND HWY",
            "address_2": "STE 102",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223032157",
            "telephone_number": "443-393-3653",
            "fax_number": "877-991-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 24TH STREET",
            "address_2": "SUITE #100",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212559",
            "telephone_number": "360-293-4655",
            "fax_number": "360-588-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSINS",
        "first_name": "JODY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "7939A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD046860",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "57012332",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0086550",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60132209",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2007259",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anacortes, WA

Sources for this page

Verify at the official NPI Registry.