Nyerere Wert Cobb

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

056010473 Issued in IL

Practice address

805 Willow Dr
Chicago Heights, IL 60411-2128

Phone

(708) 928-0780

NPI assigned

Jan 13, 2016

Last updated

Jan 13, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cobb Medical LLC

  • Occupational Therapist
  • Chicago Heights, IL
  • NPI 1679317689
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1659737195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 WILLOW DR",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604112128",
            "telephone_number": "708-928-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 WILLOW DR",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604112128",
            "telephone_number": "708-928-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "NYERERE",
        "middle_name": "WERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "IL",
            "license": "056010473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chicago Heights SLF, LLC (Prairie Green at Dixie Crossing)
• Chicago Vamc
• Yang K Chun, M.D.
• City of Chicago Heights
• Cobb Medical LLC
• Gregg S Coccaro, M.D.
• Fairouz Carpizo Codina, M.D.
• Mario Cole
• Kendralyn Coleman
• Timothy J Coleman, PT

• Gerontology Occupational Therapist in Chicago Heights, IL
• Providers in Chicago Heights, IL by specialty
• Gerontology Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.