Debra Sue Cook, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71000505 Issued in IN

Practice address

209 E Jefferson St
Plymouth, IN 46563-1861

Phone

(574) 941-3111

Fax

(574) 335-0745

NPI assigned

Apr 4, 2007

Last updated

Feb 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Saint Joseph Regional Medical Center, Inc.

  dba Saint Joseph Medical Group

  • Pulmonary Disease Physician
  • Plymouth, IN
  • NPI 1225082878
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1477675965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E CEDAR ST",
            "address_2": "STE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172057",
            "telephone_number": "574-335-8700",
            "fax_number": "574-335-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 E JEFFERSON ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465631861",
            "telephone_number": "574-941-3111",
            "fax_number": "574-335-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "DEBRA",
        "middle_name": "SUE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200190130A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000322873",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiny Clemens
• Heather Marie Clemons
• Jamie Cole, OD
• Comcare Transit, Inc.
• Madelain Contreras
• Jessica Cooper, FNP
• Lisa Cooper, LCSW
• William T. Correll, D.O.
• Kurt Corsbie, DDS
• Oriana Corsbie, DMD

• Family Nurse Practitioner in Plymouth, IN
• Providers in Plymouth, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.