Frederick G Cook, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD12674 Issued in OR

Practice address

5050 Skyline Village Loop S
Salem, OR 97306-9490

Phone

(503) 391-1110

Fax

(503) 370-4237

NPI assigned

Nov 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Willamette Valley Hospice Inc

  • Community Based Hospice Care Agency
  • Salem, OR
  • NPI 1093715070
  Medicare reassignment

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1083697965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 3RD ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044007",
            "telephone_number": "503-588-3600",
            "fax_number": "503-363-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SKYLINE VILLAGE LOOP S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973069490",
            "telephone_number": "503-391-1110",
            "fax_number": "503-370-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "FREDERICK",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD12674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233585",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jami A Conway, R.PH
• Rachel Aurora Conway
• B Scot Cook, PSY D CLINICAL PSYCH
• Cassie Cook, PA-C
• Daniel O Cook, D.C.
• Janet Lee Cook, LMT
• Tammy Cook
• William John Cook, MSW
• Jeffrey Michael Cooksey, PA-C
• Cooldown Corporation

• Family Medicine Physician in Salem, OR
• Providers in Salem, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.