Individual provider Active NPI

Regina Nateya Cooks, OTR/L

  • Pediatric Skilled Nursing Facility
  • Norcross, GA
National Provider Identifier
1558545665
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
License
3033 Issued in SC
Practice address
4940 Peachtree Industrial Blvd
310
Norcross, GA 30071-1599
Phone
(888) 416-7949
NPI assigned
Dec 26, 2007
Last updated
Dec 26, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X 3033 SC Primary

Addresses

Primary practice location

4940 Peachtree Industrial Blvd
310
Norcross, GA 30071-1599

Mailing address

379 Pinehaven St Ext
Laurens, SC 29360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3033SCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1558545665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 PINEHAVEN ST EXT",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "29360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "310",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711599",
            "telephone_number": "888-416-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKS",
        "first_name": "REGINA",
        "middle_name": "NATEYA",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "SC",
            "license": "3033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.