Active NPI
Michael Stacy Cook, D.M.D.
- Dentist
- Leakesville, MS
National Provider Identifier
1801899620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2870-95
- Practice address
- 403 Main St
Leakesville, MS 39451-6502 - Phone
- (601) 394-2467
- Fax
- (601) 394-2468
- NPI assigned
- May 24, 2005
- Last updated
- Nov 16, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2870-95 | MS | Primary |
Addresses
Primary practice location
403 Main St
Leakesville, MS 39451-6502
Mailing address
PO Box 280
Leakesville, MS 39451-0280
Phone (601) 394-2467
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09015334 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2870-95 | MS | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M. Stacy Cook, DMD | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Leakesville, MS
- NPI 1073722203
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668556800000",
"number": "1801899620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 280",
"city": "LEAKESVILLE",
"state": "MS",
"postal_code": "394510280",
"telephone_number": "601-394-2467",
"fax_number": "301-394-2468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 MAIN ST",
"city": "LEAKESVILLE",
"state": "MS",
"postal_code": "394516502",
"telephone_number": "601-394-2467",
"fax_number": "601-394-2468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "MICHAEL",
"middle_name": "STACY",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2022-11-16",
"certification_date": "2022-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "2870-95",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09015334",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leakesville, MS
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- Coastal Family Health Center, Inc
- Coastal Family Health Center, Inc
- Contona Collins, IDD WAIVER SERVICES
- Cradle to the Grave Healthcare LLC
- Amber Davis, PCCSS
- Wilkins Dedwylder, MD
- Delco Inc Dba Brookwood Manor Nursing Center
- Cynthia W Denmark, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.