RICHARD EDWARD COOKSLEY (NPI# 1942271192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942271192 |
| Entity Type | Individual |
| Full Name | RICHARD EDWARD COOKSLEY |
| Credential | PA |
| Practice Address |
115 S Pine St Canyonville OR 97417-9648 |
| Mailing Address |
Po Box 888 Canyonville OR 97417-0888 |
| Practice Telephone | 5418394211 |
| Practice Fax Number | 5418394983 |
| Mailing Telephone | 5418394211 |
| Mailing Fax Number | 5418394983 |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2018-10-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA00272 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 165878 | 05 | |
| OR | STATE LICENSE | PA00272 | 01 |
| OR | RAILROAD MEDICARE | 930087876 | 01 |
| Street Address |
115 S PINE ST |
| City | CANYONVILLE |
| State | OR |
| Zip Code | 97417-9648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992775092 | Anandita Tiwari | Internal Medicine | 115 S Pine St, Canyonville, OR 97417-9648 | 2006-01-23 |
| 1902340219 | Rhonda Darling | Social Worker | 115 S Pine St, Canyonville, OR 97417-9648 | 2016-12-06 |
| 1679948806 | Dr. Anna, LLC | Family Medicine | 115 S Pine St, Canyonville, OR 97417-9648 | 2015-12-14 |
| 1073586319 | Jon Douglas Gambill | Physician Assistant | 115 S Pine St, Canyonville, OR 97417-9648 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871611350 | Forest Glen | Assisted Living Facility | 200 Sw Frontage, Canyonville, OR 97417 | 2007-03-26 |
| 1205971439 | Ronald E Wilmot | Counselor | 152 Bettys Way St, 481, Canyonville, OR 97417 | 2007-02-21 |
| 1841333135 | Canyonville Chiropractic Inc | Chiropractor | 134 Se 3rd Street, Canyonville, OR 97417 | 2007-02-15 |
| 1407475577 | Robert Bakkegard | Pharmacist | 314 S Main Street, Canyonville, OR 97417 | 2020-04-09 |
| 1316322597 | Carrie Lovemark | Acupuncturist | 214 S Main St, Canyonville, OR 97417 | 2015-07-29 |
| 1255521225 | Falk Family Medicine, LLC | Family Medicine | 115 Sw Pine Street, Canyonville, OR 97417 | 2007-07-26 |
| 1689891269 | David Allen Stevens | Pharmacist | 314 S Main St, Canyonville, OR 97417 | 2007-04-18 |
| 1508987645 | James Brian Siegel | Chiropractor | 134 Se 3rd Street, Canyonville, OR 97417 | 2007-04-03 |
| 1144377433 | Gregory Alan Falk | Family Medicine | 115 Sw Pine, Canyonville, OR 97417-0198 | 2007-01-05 |
| 1295882512 | Bonita Acosta | Nurse Practitioner | 115 Sw Pine Street, Canyonville, OR 97417-0198 | 2007-01-05 |
| Find all providers in zip 97417 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073586319 | Jon Douglas Gambill | Physician Assistant | 115 S Pine St, Canyonville, OR 97417-9648 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808605 | Pilar Lorena Lopez | Physician Assistant | 7675 Sw Spruce St, Tigard, OR 97223-8723 | 2020-10-15 |
| 1730787615 | Michael Hisao Mun Ho Pang | Physician Assistant | 1245 Sw 160th Ave, Beaverton, OR 97006-5052 | 2020-10-13 |
| 1144834805 | Logan Michael Johnston | Physician Assistant | 3319 Edgeview Ln, Forest Grove, OR 97116-1094 | 2020-09-01 |
| 1285255851 | Darby Samantha Jalbert | Physician Assistant | 2480 Liberty St Ne Ste 110, Salem, OR 97301-8381 | 2020-05-05 |
| 1033751433 | Trisha K Loch | Physician Assistant | 781 W Central, Sutherlin, OR 97479 | 2019-10-17 |
| 1154805729 | Ronald William Strohmeyer | Physician Assistant | 2327 S.w. 4th Ave, Ontario, OR 97914 | 2018-09-19 |
| 1740797166 | Joseph Something | Physician Assistant | 4800 Sw 76th Ave, Portland, OR 97225-1804 | 2018-01-08 |
| 1235687013 | Satchel Harry | Physician Assistant | 417 Sw 117th Ave Fl 2, Portland, OR 97225-5924 | 2016-09-21 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1659828044 | Ryan Jones | Physician Assistant | 1775 Thompson Rd Bay Or97420, Coos Bay, OR 97420-2125 | 2016-09-02 |
| Find all providers with the same taxonomy | ||||
| City | CANYONVILLE |
| Zip Code | 97417 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.