Individual provider Active NPI

Alan Richard Cook, PH.D.

  • Clinical Psychologist
  • Winston Salem, NC
National Provider Identifier
1558453084
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1351 Issued in NC
Practice address
2990 Bethesda PL
Suite 602-a
Winston Salem, NC 27103-3318
Phone
(336) 768-8281
Fax
(336) 768-5685
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1351 NC Primary

Addresses

Primary practice location

2990 Bethesda PL
Suite 602-a
Winston Salem, NC 27103-3318

Mailing address

2990 Bethesda PL
Suite 602-a
Winston Salem, NC 27103-3318
Phone (336) 768-8281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120229000387 NC Practitioner - Clinical Psychologist 3678593670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2990 Bethesda PL
Suite 602B
Winston Salem, NC 27103-3309
Phone (336) 768-8281

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1351NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Directions - Treatment Center for Anxiety and Depression CurrentSince Jul 1, 1988 Accepting new patients

Locations

2990 Bethesda Pl
Ste 602B
Winston Salem, NC 27103
Phone (336) 768-8281

2990 Bethesda Pl
Ste 602
Winston Salem, NC 27103
Phone (336) 768-8281

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1558453084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 BETHESDA PL",
            "address_2": "SUITE 602-A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033318",
            "telephone_number": "336-768-8281",
            "fax_number": "336-768-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 BETHESDA PL",
            "address_2": "SUITE 602-A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033318",
            "telephone_number": "336-768-8281",
            "fax_number": "336-768-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "ALAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "1351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.