Kevin Wade Cook, PHARMACIST

Primary specialty

PharmacistTaxonomy code 183500000X

License

21780 Issued in TN

Practice address

2490 Parr Ave Ste 9
Dyersburg, TN 38024-2030

Phone

(731) 285-0844

Fax

(731) 285-0885

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

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.

• BCP 1, LLC

  • Family Medicine Physician
  • Dyersburg, TN
  • NPI 1124603402
  NPD (past)
• C & C Pharmacy, LLC

  • Community/Retail Pharmacy
  • Dyersburg, TN
  • NPI 1316267487
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 21, 2011.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1124170816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 WESTWOOD CV",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380245284",
            "telephone_number": "731-285-0844",
            "fax_number": "731-285-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 PARR AVE STE 9",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242030",
            "telephone_number": "731-285-0844",
            "fax_number": "731-285-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "KEVIN",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "21780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Gray Conner, MS, RD, LDN
• Suzanne C. Constant, R.N.
• Convienent Care Clinic
• Damaris F Cook, AUD CCC-A
• Jobeth Cook, SLP
• Erica Cornelison, OTD, OTR/L
• Susan H Cox, DMD
• Brad F Creekmore, FNP
• Patsy Elaine Crihfield, MSN, RN, APRN, BC
• Eddie Lee Crocker, PT

• All providers in Dyersburg, TN
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.