Betty Jo Cooley, L.P.N.

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

100689 Issued in AK

Practice address

801 S Hermon Rd
Wasilla, AK 99654-7311

Phone

(907) 631-3971

Fax

(907) 631-4085

NPI assigned

Sep 8, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Sunrise House Assisted Living Home II

  • Assisted Living Facility
  • Wasilla, AK
  • NPI 1891032124
  NPD (past) Authorized official
• Sunrise Assisted Living

  • Assisted Living Facility
  • Wasilla, AK
  • NPI 1134376973
  NPD (past)

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1508014077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S HERMON RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547311",
            "telephone_number": "907-631-3971",
            "fax_number": "907-631-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S HERMON RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547311",
            "telephone_number": "907-631-3971",
            "fax_number": "907-631-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "BETTY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "AK",
            "license": "100689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Allan Cook, LCSW
• Logan Lee Cook, COUNSELOR TECHNICIAN
• Tyra Cook
• Mekayla Rose Cooks
• Paul Cooks
• Patricia C Cooley
• Theresa Mae Cooley, LMT
• Alexandra Jordan Louise Coon Goss, OD
• Lynn J Coon, O.D.
• Kyle Cooney

• Physical Disabilities Residential Treatment Facility in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Physical Disabilities Residential Treatment Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.