COOK CHILDREN'S URGENT CARE SOUTHLAKE - NPI 1114222312

Q: What is Cook Children's Medical Center's NPI number?

The NPI number for Cook Children's Medical Center is 1114222312. It was assigned to this organization in the NPPES registry on January 19, 2011. The provider is doing business as Cook Children's Urgent Care Southlake.

Q: What is Cook Children's Medical Center's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

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About Cook Children's Urgent Care Southlake NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COOK CHILDREN'S URGENT CARE SOUTHLAKE (NPI 1114222312) is a healthcare organization registered as a pediatrics in Southlake, Texas and active in the NPI registry since January 2011. The organization holds a CLIA Waiver certificate valid through April 28, 2027 and lists Cory R Rhoades, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1114222312

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameCOOK CHILDREN'S MEDICAL CENTER

Location Address2727 E SOUTHLAKE BLVDSouthlake, TX 76092-6613

Mailing AddressPo Box 99213Fort Worth, TX 76199-0213 · (682) 885-1860 · Fax (682) 885-1396

Phone(682) 885-6000

Fax(682) 885-6050

Organization SubpartYes

Authorized OfficialCory R RhoadesChief Financial Officer · (682) 885-4480

Enumeration DateJanuary 19, 2011

Last NPPES UpdateMay 26, 20213 updates tracked since enumeration

NPPES CertifiedMay 26, 2021

✔ NPI 1114222312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in TX · 000332

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

2727 E SOUTHLAKE BLVD, Southlake, TX 76092

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Other Names 1

Doing Business AsCook Children's Urgent Care Southlake

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2018154

Cook Children's Southlake Urgent Care Center Lab · Southlake, TX

Active · expires Apr 28, 2027

CLIA Number45D2018154

Laboratory TypeAncillary Testing Site In Health Care Center

Certificate Effective DateApril 29, 2025

Certificate Expiration DateApril 28, 2027

Laboratory DirectorStacey A. Berry

Laboratory Phone(682) 885-4296

Laboratory LocationCook Children's Southlake Urgent Care Center Lab2727 East Southlake Blvd, Southlake, TX 76092

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTI LEE WEST PA-C

Physician Assistant