Individual provider Active NPI

Howard B. Kook, D.C.

  • Chiropractor
  • Maplewood, NJ
National Provider Identifier
1104870559
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC02880 Issued in NJ
Practice address
1955 Springfield Ave
Suite 104
Maplewood, NJ 07040-3441
Phone
(973) 762-2526
Fax
(973) 762-1713
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC02880 NJ Primary

Addresses

Primary practice location

1955 Springfield Ave
Suite 104
Maplewood, NJ 07040-3441

Mailing address

1955 Springfield Ave
Suite 104
Maplewood, NJ 07040-3441
Phone (973) 762-2526

Other identifiers 2

IdentifierTypeStateIssuer
8764603MedicaidNJ
223530677OtherTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120123000110 NJ Practitioner - Chiropractic 4284801838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1955 Springfield Ave
Maplewood, NJ 07040-3417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC02880NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Howard B. Kook, D.C., P.C. Chiropractor CurrentSince Jan 1, 1989 Accepting new patients

Locations

1955 Springfield Ave
Ste 104
Maplewood, NJ 07040
Phone (973) 762-2526

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1104870559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 SPRINGFIELD AVE",
            "address_2": "SUITE 104",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403441",
            "telephone_number": "973-762-2526",
            "fax_number": "973-762-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 SPRINGFIELD AVE",
            "address_2": "SUITE 104",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403441",
            "telephone_number": "973-762-2526",
            "fax_number": "973-762-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOK",
        "first_name": "HOWARD",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC02880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8764603",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "223530677",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.