Jennifer Blake Cook

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110010449 Issued in VA

Practice address

44 Medical Park Blvd Ste D
Petersburg, VA 23805-9351

Phone

(804) 520-6730

NPI assigned

Sep 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bon Secours Medical Group Richmond Specialty Care LLCGroup PAC ID 8022440056, 350 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bon Secours Southside Medical Center Hospital, Petersburg, VA, CCN 490067

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcook2743437@direct.bsmhealth.org

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.

• Bon Secours Medical Group Richmond Specialty Care LLC

  • Cardiovascular Disease Physician
  • Richmond, VA
  • NPI 1477112225
  Medicare reassignment Care Compare group NPD
• Bon Secours Medical Group Richmond Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Midlothian, VA
  • NPI 1841029287
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bon Secours Mercy Health Petersburg LLC

  • General Acute Care Hospital
  • Petersburg, VA
  • NPI 1720623853
  Care Compare affiliation

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1689452146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 N CHARLES ST APT 2106",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014026",
            "telephone_number": "804-572-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 MEDICAL PARK BLVD STE D",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059351",
            "telephone_number": "804-520-6730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 W Fayette St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011756",
            "country_code": "US",
            "telephone_number": "804-572-3707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "JENNIFER",
        "middle_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Compassionate Rides LLC
• Christian Alexander Conley, PA-C
• Todd A Connor, OT/L
• Margaret J Constante, FNP-C
• Convenient Health Care, Incorporated
• Nancy Clay Cook, RPH
• Michelle A Cooper, PAC
• Shantel Abraham Cooper, LPC
• Casey Grant Costa, MD
• Deborah Goodrich Cousins, CPHT

• Physician Assistant in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.