Individual provider Active NPI

Latrisha Burks Cooley, MEDICAL ASSISTANT

  • In Home Supportive Care Agency
  • Mobile, AL
National Provider Identifier
1932770658
Registry record updated Jul 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
2113702 Issued in AL
Practice address
2112 Highland CT
Mobile, AL 36605-2315
Phone
(251) 767-0778
NPI assigned
Jul 3, 2021
Last updated
Jul 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 2113702 AL Primary

Addresses

Primary practice location

2112 Highland CT
Mobile, AL 36605-2315

Mailing address

2112 Highland CT
Mobile, AL 36605-2315
Phone (251) 767-0778

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
2113702ALMDIn Home Supportive Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1625270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625270400000",
    "number": "1932770658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 HIGHLAND CT",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366052315",
            "telephone_number": "251-767-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 HIGHLAND CT",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366052315",
            "telephone_number": "251-767-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "LATRISHA",
        "middle_name": "BURKS",
        "credential": "MEDICAL ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-03",
        "last_updated": "2021-07-03",
        "certification_date": "2021-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "AL",
            "license": "2113702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2021; 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.