Victoria Anne Cooke

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110-008938 Issued in VA

Practice address

102 Queens Cres
Williamsburg, VA 23185-3328

Phone

(681) 285-9627

NPI assigned

May 6, 2022

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)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrated Dermatology of Tidewater LLC

  • Dermatology Physician
  • Norfolk, VA
  • NPI 1801238472
  NPD (past)

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1558007211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 QUEENS CRES",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 QUEENS CRES",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853328",
            "telephone_number": "681-285-9627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "486 Blackberry Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265084869",
            "country_code": "US",
            "telephone_number": "681-285-9627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOKE",
        "first_name": "VICTORIA",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-008938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constant Care
• Constant Care Health Care Solutions LLC
• Contemplation and Healing Institute
• Monica Contract, D.M.D.
• Joseph Oliver Converse, MD
• Bonnie Webster Cooley, FNP-BC
• Hope Begley Cooper, LCSW
• Rose Toms Cope, L.C.S.W.
• Mark Shawn Cordle II, PHARMD
• Megan Cordova

• Physician Assistant in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.