Jennifer Q Cook, CNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R865021 Issued in MS

Practice address

624 Highway 51 N
Brookhaven, MS 39601-2337

Phone

(601) 835-2100

Fax

(601) 835-0451

NPI assigned

Aug 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19538/brand/2/csg/1/fhir/r4
• Direct secure messaging: jennifer.cook.1@19538.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/6393/brand/1/csg/41/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/19538/brand/1/csg/1/fhir/r4

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.

• Gluckstadt TC Kids, LLC

  • Pediatrics Physician
  • Madison, MS
  • NPI 1255947297
  Medicare reassignment NPD
• KDMC Physician Clinics LLC

  • Multi-Specialty Clinic/Center
  • Brookhaven, MS
  • NPI 1861739161
  Medicare reassignment NPD
• Kings Daughters Medical Center

  • Anesthesiology Physician
  • Brookhaven, MS
  • NPI 1043245368
  Medicare reassignment NPD
• King'S Daughters Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Brookhaven, MS
  • NPI 1881476364
  NPD
• King'S Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464
  NPD
• University Surgery Associates, PLLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Jackson, MS
  • NPI 1356451652
  NPD (past)

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

{
    "created_epoch": "1186876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1730371964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 HIGHWAY 51 N",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012337",
            "telephone_number": "601-835-2100",
            "fax_number": "601-835-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 HIGHWAY 51 N",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012337",
            "telephone_number": "601-835-2100",
            "fax_number": "601-835-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "JENNIFER",
        "middle_name": "Q",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-12",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "R865021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07400054",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Porcia Combs
• Community Wellness Group LLC
• Complete Family Medical, LLC
• Continuum Rehab Therapy, LLC
• Ashley Sharnita Cook
• Kelly L Covington, M.S., CCC-SLP
• Anne Houston Craig, LCSW
• Cole Shane Craighead, MD
• James E Crane Jr.
• Crossroads Adult Day Care

• Pediatric Nurse Practitioner in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Pediatric Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.