Individual Healthcare Provider
Jordan Fayth Cooke, PA-C
Provider's NPPES record last updated: February 22, 2022
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1033628383
- Primary Specialty
- Physician Assistant — Surgical
- Practice Location
- Tyler, Texas
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 19, 2026, 9:36 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Physician Assistant
Surgical
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363AS0400X
Provider-Reported License Information
- Physician Assistant (Texas)
- PA11584
Practice Locations
Practice Location
8101 S Broadway Ave
Tyler, Texas 75703-5469
Phone: (903) 939-7500
Additional Practice Location
305 W 20th St
Mt Pleasant, Texas 75455-2327
Phone: (903) 939-7500
Fax: (903) 939-7728
Additional Practice Location
708 E Corsicana St
Athens, Texas 75751-2627
Phone: (903) 939-7500
Fax: (903) 939-7728
Additional Practice Location
925 W Loop 281
Longview, Texas 75604-2918
Phone: (903) 939-7500
Fax: (903) 939-7728
Additional Practice Location
3414 Golden Rd
Tyler, Texas 75701-8336
Phone: (903) 939-7500
Fax: (903) 939-7728
Record Information
- Enumeration Date
- September 28, 2017
- Provider's NPPES Record Last Updated
- February 22, 2022
- Certification Date
- February 22, 2022
- NPISignal NPPES Dataset
- August 2026
See Something Wrong?
Incorrect provider information
Everything on this page comes directly from the NPPES data CMS publishes. NPISignal cannot edit a provider's record — only the provider or organization can, directly through NPPES.
Update a record through NPPESSomething wrong with this page?
If NPISignal is displaying this data incorrectly — a formatting error, a broken link, a mismatch with the source file — let us know.
Report a display issue