Randolph D Cooke, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3124 Issued in AZ

Practice address

300 Hospital Rd
Family Medicine Clinic
Ft. Gordon, GA 30905

Phone

(706) 787-9352

NPI assigned

Nov 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1861475899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL ROAD",
            "address_2": "FAMILY MEDICINE CLINIC",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL RD",
            "address_2": "FAMILY MEDICINE CLINIC",
            "city": "FT. GORDON",
            "state": "GA",
            "postal_code": "30905",
            "telephone_number": "706-787-9352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "RANDOLPH",
        "middle_name": "D",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latonya Collins, RN, BSN-MSM
• Clark Michael Comeaux, D.D.S.
• Christian Clarke Conlon, MD
• Ramon Contreras, PT, DPT
• Ronald Gene Cook, DPH
• Nathanial Kelsey Copeland, MD, MTM&H
• Cesar A Costales, OD, MHA, FAAO
• Jennifer Jordan Cote, DMD
• Lemuel Lee Covington, D.M.D.
• Mark Stephen Craig

• Clinical Psychologist in Ft. Gordon, GA
• Providers in Ft. Gordon, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; 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.