Individual provider Active NPI

Allen T Cooke, NP

  • Family Nurse Practitioner
  • Summerville, SC
National Provider Identifier
1851909162
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24143 Issued in SC
Practice address
809 N Cedar St
Summerville, SC 29483-6605
Phone
(843) 871-9440
Fax
(843) 871-5932
NPI assigned
Jul 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 24143 SC Primary

Addresses

Primary practice location

809 N Cedar St
Summerville, SC 29483-6605

Mailing address

PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 695-6071

Other practice location 1

2566 Ashley River Rd
Charleston, SC 29414-4605
Phone (843) 801-1643

Other identifiers 1

IdentifierTypeStateIssuer
NP7217MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20201104001703 SC Practitioner - Nurse Practitioner 7911317813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Palmetto Primary Care Physicians LLCGroup PAC ID 4880508068, 148 clinicians

Practice addresses (Care Compare)

809 N Cedar St
Summerville, SC 29483-6605
Phone (843) 695-6071

Hospital & facility affiliations

  • Interim Healthcare Home health agency, North Charleston, SC, CCN 427132
  • Trident Medical Center Hospital, Charleston, SC, CCN 420079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Mar 1, 2021 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Mar 1, 2021 Accepting new patients
Palmetto Primary Care Physicians, LLC Past Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

2500 Elms Center Rd
North Charleston, SC 29406
Phone (763) 348-2075

809 N Cedar St
Summerville, SC 29483
Phone (843) 851-9440

201 Sigma Dr
Ste 100
Summerville, SC 29486
Phone (843) 820-3397

85 Springview Ln
Unit C
Summerville, SC 29485
Phone (843) 875-0600

Interoperability endpoints

  • Direct secure messaging: allen.cooke@ppcp1.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1851909162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 N CEDAR ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836605",
            "telephone_number": "843-871-9440",
            "fax_number": "843-871-5932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2566 Ashley River Rd",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294144605",
            "country_code": "US",
            "telephone_number": "843-801-1643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOKE",
        "first_name": "ALLEN",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-22",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP7217",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.