Individual provider Active NPI

Cassie Abigail Cochrane, PT

  • Physical Therapist
  • Vienna, WV
National Provider Identifier
1568783892
Registry record updated Nov 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT004046 Issued in WV
Practice address
1605 Grand Central Ave
Vienna, WV 26105-1081
Phone
(304) 295-7290
Fax
(304) 295-5922
NPI assigned
Jun 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT004046 WV Primary
Physical Therapist 225100000X 6196 SC

Addresses

Primary practice location

1605 Grand Central Ave
Vienna, WV 26105-1081

Mailing address

1605 Grand Central Ave
Vienna, WV 26105-1081
Phone (304) 295-7290

Other practice location 1

8 Hospital Center Blvd Ste 250
Hilton Head Island, SC 29926-8702
Phone (843) 671-7342

Other names 1

  • Cassie Abigail Willis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190520000080 WV Practitioner - Physical Therapist in Private Practice 6800080896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Natalie L Cooke LLCGroup PAC ID 4082911268, 13 clinicians

Practice addresses (Care Compare)

1605 Grand Central Ave
Vienna, WV 26105-1081
Phone (304) 295-5505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6196SCMDPhysical Therapist
PT004046WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Natalie L Cooke LLC Physical Therapist CurrentSince Feb 23, 2019 Accepting new patients
Riverview Health Clinic, PLLC Physical Therapist PastSince Feb 23, 2019 Accepting new patients

Locations

915 Emerson Ave
Parkersburg, WV 26104
Phone (304) 295-7290

1605 Grand Central Ave
Vienna, WV 26105
Phone (304) 295-5505

Organizations & group practices 2

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": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667606400000",
    "number": "1568783892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 GRAND CENTRAL AVE",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051081",
            "telephone_number": "304-295-7290",
            "fax_number": "304-295-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 GRAND CENTRAL AVE",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051081",
            "telephone_number": "304-295-7290",
            "fax_number": "304-295-5922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Hospital Center Blvd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Hilton Head Island",
            "state": "SC",
            "postal_code": "299268702",
            "country_code": "US",
            "telephone_number": "843-671-7342",
            "fax_number": "843-671-7343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COCHRANE",
        "first_name": "CASSIE",
        "middle_name": "ABIGAIL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2022-11-05",
        "certification_date": "2022-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT004046",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6196",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIE",
            "last_name": "WILLIS",
            "middle_name": "ABIGAIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vienna, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.