Individual provider Active NPI

Nicole Marie Cooley, LPN

  • Licensed Practical Nurse
  • Malone, NY
National Provider Identifier
1902522428
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
332636 Issued in NY
Practice address
31 6TH St
Malone, NY 12953-1246
Phone
(518) 483-3261
NPI assigned
Oct 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 332636 NY Primary

Addresses

Primary practice location

31 6TH St
Malone, NY 12953-1246

Mailing address

1379 Teboville Rd
Malone, NY 12953-3741

Other names 1

  • Nicole Marie Marks Former name

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

LicenseStateTypeSpecialty
332636NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen Advocates, Inc CurrentSince Oct 23, 2022 Accepting new patients
Citizen Advocates, Inc CurrentSince Oct 23, 2022 Accepting new patients

Locations

31 6th St
Malone, NY 12953
Phone (518) 651-2254

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1902522428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1379 TEBOVILLE RD",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129533741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 6TH ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531246",
            "telephone_number": "518-483-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "332636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MARKS",
            "middle_name": "MARIE",
            "credential": "MAIDEN NAME",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Malone, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.