Individual provider Active NPI

Pamela M. Cookingham, PT

  • Physical Therapist
  • Clovis, CA
National Provider Identifier
1609972900
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT19604 Issued in CA
Practice address
221 West Fir Ave
Ste 105
Clovis, CA 93611
Phone
(559) 325-3444
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT19604 CA Primary

Addresses

Primary practice location

221 West Fir Ave
Ste 105
Clovis, CA 93611

Mailing address

221 West Fir Ave
Ste 105
Clovis, CA 93611
Phone (559) 325-3444

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
19604CAMDAddiction (Substance Use Disorder) Counselor
PT19604CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Physical Therapy Physical Therapist PastSince Dec 10, 2012 Accepting new patients

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609972900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 WEST FIR AVE",
            "address_2": "STE 105",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "93611",
            "telephone_number": "559-325-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 WEST FIR AVE",
            "address_2": "STE 105",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "93611",
            "telephone_number": "559-325-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKINGHAM",
        "first_name": "PAMELA",
        "middle_name": "M.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT19604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

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