Shavon Cooke

Primary specialty

Medical Toxicology (Preventive Medicine) PhysicianTaxonomy code 2083T0002X

License

43990-167-465-8163 Issued in VA

Practice address

168 Williams St
Portsmouth, VA 23704-1835

Phone

(757) 759-1619

NPI assigned

Nov 3, 2022

Last updated

Jan 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1780391284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 EDEN WAY NORTH PMB 339",
            "address_2": "STE 118",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "23320",
            "telephone_number": "757-759-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 WILLIAMS ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237041835",
            "telephone_number": "757-759-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "SHAVON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-03",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083T0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Medical Toxicology",
            "state": "VA",
            "license": "43990-167-465-8163",
            "primary": true
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "VA",
            "license": "43990-167-465-8163",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Continental Medical Services PLLC
• Eilish M Conway, LCSW
• Christina Jasmine Conzater, PHARMD
• Colleen Marie Cook, MD
• Madison Cook
• Amanda Priest Cooper, PT, DPT
• Elizabeth Sara Cooper, DO
• Jimmy Cooper Jr., DHA, FNP-C
• Kimberly A. Copeland, PSY.D.
• Julianne Corcoran, DO

• Medical Toxicology (Preventive Medicine) Physician in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Medical Toxicology (Preventive Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.