Mrs Carol A Cooke, CRNP - Medicare Nurse Practitioner in Centerville, OH

Mrs Carol A Cooke, CRNP is a medicare enrolled "Nurse Practitioner - Family" physician in Centerville, Ohio. She graduated from medical school in 1997 and has 27 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Kettering Independent Medical Group Inc and her current practice location is 6438 Wilmington Pike, Suite 300, Centerville, Ohio. You can reach out to her office (for appointments etc.) via phone at (937) 848-4850.

Mrs Carol A Cooke is licensed to practice in Ohio (license number COA05642NP) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1144496985.

Contact Information

Mrs Carol A Cooke, CRNP
6438 Wilmington Pike, Suite 300,
Centerville, OH 45459
(937) 848-4850
(937) 848-4858



Physician's Profile

Full NameMrs Carol A Cooke
GenderFemale
SpecialityNurse Practitioner
Experience27 Years
Location6438 Wilmington Pike, Centerville, Ohio
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mrs Carol A Cooke graduated from medical school in 1997
  NPI Data:
  • NPI Number: 1144496985
  • Provider Enumeration Date: 05/01/2008
  • Last Update Date: 01/28/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 3678724721
  • Enrollment ID: I20121119000367

Medical Identifiers

Medical identifiers for Mrs Carol A Cooke such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1144496985NPI-NPPES
RX05642OtherOHCERTIFICATE TO PRESCRIBE
0074036MedicaidOH
COA05642NPOtherOHLICENSE NP

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207V00000XObstetrics & Gynecology RN212344 (Ohio)Secondary
363LF0000XNurse Practitioner - Family COA05642NP (Ohio)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Soin Medical CenterBeaver creek, OHHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Kettering Independent Medical Group Inc3173710936586

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Carol A Cooke allows following entities to bill medicare on her behalf.
Entity NameAlliance Physicians Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437125572
PECOS PAC ID: 0840104360
Enrollment ID: O20031118000529

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Entity NameKettering Independent Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629387865
PECOS PAC ID: 3173710936
Enrollment ID: O20101207000425

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Carol A Cooke is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Carol A Cooke, CRNP
6438 Wilmington Pike Ste 300,
Centerville, OH 45459-7021

Ph: (937) 848-4850
Mrs Carol A Cooke, CRNP
6438 Wilmington Pike, Suite 300,
Centerville, OH 45459

Ph: (937) 848-4850

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