Individual provider Active NPI

Deborah Cook, PT

  • Specialist
  • Myrtle Beach, SC
National Provider Identifier
1619904752
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MT39 Issued in ME
Practice address
3675 Spruce Dr
Myrtle Beach, SC 29577-5005
Phone
(843) 685-4981
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT2399 ME
Specialist 174400000X MT39 ME Primary

Addresses

Primary practice location

3675 Spruce Dr
Myrtle Beach, SC 29577-5005

Mailing address

3675 Spruce Dr
Myrtle Beach, SC 29577-5005
Phone (843) 685-4981

Other identifiers 3

IdentifierTypeStateIssuer
007016OtherMEBLUE CROSS BLUE SHIELD
MN4071OtherMEHARVARD PILGRIM
7966435OtherMECIGNA HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071102000269 ME Practitioner - Physical Therapist in Private Practice 6002857885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Therapy Outpatient Services of Me, LLCGroup PAC ID 0345639001, 16 clinicians

Practice addresses (Care Compare)

30 Community Dr
Camden, ME 04843-2061
Phone (207) 230-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT39MEMDSpecialist
5122SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Therapy Outpatient Services of Me, LLC CurrentSince Aug 23, 2023 Accepting new patients
Preferred Therapy Outpatient Services of Me, LLC CurrentSince Aug 23, 2023 Accepting new patients

Locations

850 Silas Deane Hwy
Fl 2
Wethersfield, CT 06109
Phone (860) 610-0400

30 Community Dr
Camden, ME 04843
Phone (207) 230-6100

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1619904752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 SPRUCE DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775005",
            "telephone_number": "843-685-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 SPRUCE DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775005",
            "telephone_number": "843-685-4981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "DEBORAH",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ME",
            "license": "PT2399",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ME",
            "license": "MT39",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "007016",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "MN4071",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "7966435",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.