Individual provider Active NPI

Molly Grey Cook

  • Family Nurse Practitioner
  • Easley, SC
National Provider Identifier
1962109546
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27496 Issued in SC
Practice address
105 Franklin Square Way Ste a
Easley, SC 29642-3715
Phone
(864) 442-4110
Fax
(864) 442-4126
NPI assigned
Feb 14, 2023
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 27496 SC Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

105 Franklin Square Way Ste a
Easley, SC 29642-3715

Mailing address

105 Franklin Square Way Ste a
Easley, SC 29642-3715
Phone (864) 442-4110

Other practice location 1

1601 Greene St
Columbia, SC 29208-4001
Phone (803) 777-7412

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
I20230822002623 SC Practitioner - Nurse Practitioner 5890158984 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27496SCMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Onsite Healthcare and Wellness LLC CurrentSince Aug 2, 2023 Accepting new patients

Locations

105 Franklin Square Way
#A
Easley, SC 29642
Phone (864) 442-4019

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.

NPI Registry JSON

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1962109546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 FRANKLIN SQUARE WAY STE A",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423715",
            "telephone_number": "864-442-4110",
            "fax_number": "864-442-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 FRANKLIN SQUARE WAY STE A",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423715",
            "telephone_number": "864-442-4110",
            "fax_number": "864-442-4126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Greene St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292084001",
            "country_code": "US",
            "telephone_number": "803-777-7412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "MOLLY",
        "middle_name": "GREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "27496",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.