Crit Reon Cooksey, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

038452 Issued in GA

Practice address

3827 Roswell Road
Suite 100B
Marietta, GA 30062-6262

Phone

(678) 290-3396

Fax

(770) 579-0669

NPI assigned

Dec 18, 2006

Reactivated

Sep 5, 2008

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of Arkansas College of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Highland Rivers Community Service Board 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Highland Rivers Community Service Board

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1447256243

  GA

  Medicare reassignment Care Compare group NPD
• View Point Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lawrenceville, GA
  • NPI 1609853860

  GA

  Medicare reassignment
• Pathways Center for Behavioral & Developmental Growth

  • Community/Behavioral Health Agency
  • Newnan, GA
  • NPI 1407492846
  NPD (past)
• Pathways Center for Behavioral and Developmental Growth

  • Community/Behavioral Health Agency
  • Newnan, GA
  • NPI 1013289255
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1699838045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3827 ROSWELL ROAD",
            "address_2": "SUITE 100B",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626262",
            "telephone_number": "678-290-3396",
            "fax_number": "770-579-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3827 ROSWELL ROAD",
            "address_2": "SUITE 100B",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626262",
            "telephone_number": "678-290-3396",
            "fax_number": "770-579-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKSEY",
        "first_name": "CRIT",
        "middle_name": "REON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2011-06-24",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "038452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000711829D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PIN",
            "identifier": "GRP2111",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Cook, LCSW
• Sheryl L. Cook, NP-C
• John Edward Cooke, MD
• Kristina Cooke, LCSW
• Thomas Ryan Cooke
• Michael R Cool, PA
• Samod Cooley
• Amy Coombs
• Andre Victor Coombs, M.D.
• Shevita Andrea Cooper-Martin, RBT

• All providers in Marietta, GA
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.