Individual provider Active NPI

Christopher Andrew Cook, DMD

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1013059369
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7560 Issued in KY
Practice address
4516 Cane Run Rd
Louisville, KY 40216-3422
Phone
(502) 448-1003
Fax
(502) 448-1021
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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 7560 KY Primary
Dentist 122300000X 7560 KY

Addresses

Primary practice location

4516 Cane Run Rd
Louisville, KY 40216-3422

Mailing address

PO Box 16866
Louisville, KY 40256-0866
Phone (502) 448-1003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161117002632 OH Order and Referring Only - DentistPractitioner - Dentist 4385923135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7560KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cane Run Smile Center, Inc. General Practice Past Accepting new patients

Networks

  • TN PPO C-SNP
  • KY PPO C-SNP
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6

Organizations & group practices 1

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1013059369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16866",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402560866",
            "telephone_number": "502-448-1003",
            "fax_number": "502-448-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 CANE RUN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402163422",
            "telephone_number": "502-448-1003",
            "fax_number": "502-448-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "CHRISTOPHER",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7560",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "7560",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.