Kevin Joseph Cook, D.C.
Individual provider Active NPI Chiropractor · Ottawa, KS
NPI 1053556589 · NPPES record last updated Dec 12, 2008
Key facts
- NPI
- 1053556589
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 0105235 (KS)
- Practice address
- 112 E 17TH St
Ottawa, KS 66067-3800 - Phone
- (913) 731-0287
- NPI assigned
- Dec 12, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090420000572 | KS | Practitioner - Chiropractic | 2062569502 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0105235 | KS | Yes |
Addresses
Primary practice location
112 E 17TH St
Ottawa, KS 66067-3800
Mailing address
112 E 17TH St
Ottawa, KS 66067-3800
Phone (913) 731-0287
Other providers in Ottawa, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.