Individual provider Active NPI

Gregory Cochrane, D.D.S.

  • Dentist
  • La Crosse, WI
National Provider Identifier
1003299355
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1001163 Issued in WI
Practice address
3143 State Rd
Suite 100
La Crosse, WI 54601-6964
Phone
(608) 788-0030
NPI assigned
Jul 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1001163 WI
Dentist 122300000X 1001163 WI Primary

Addresses

Primary practice location

3143 State Rd
Suite 100
La Crosse, WI 54601-6964

Mailing address

3143 State Rd Ste 100
La Crosse, WI 54601-6964
Phone (608) 788-0030

Other practice location 1

310 S Nelson Dr Ste C
Arcadia, WI 54612-1898
Phone (608) 323-3888

Other practice location 2

519 McHugh Rd
Holmen, WI 54636-9256
Phone (608) 526-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1001163WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
River Town Dental, LLC Dentist PastSince Jun 21, 2022 Accepting new patients
Arcadia Dental Center General Practice Past Accepting new patients
River Town Dental, LLC Dentist PastSince Jan 1, 2021 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1003299355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3143 STATE RD STE 100",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546016964",
            "telephone_number": "608-788-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3143 STATE RD",
            "address_2": "SUITE 100",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546016964",
            "telephone_number": "608-788-0030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 S Nelson Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "WI",
            "postal_code": "546121898",
            "country_code": "US",
            "telephone_number": "608-323-3888",
            "fax_number": "608-323-3889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "519 McHugh Rd",
            "address_purpose": "LOCATION",
            "city": "Holmen",
            "state": "WI",
            "postal_code": "546369256",
            "country_code": "US",
            "telephone_number": "608-526-9300",
            "fax_number": "608-526-9310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COCHRANE",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-06",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001163",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.