Individual provider Active NPI

Robert Bruce Cochrane, DDS

  • Periodontics
  • Fort Dodge, IA
National Provider Identifier
1144309725
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
6251 Issued in IA
Practice address
1611 First Ave North
Fort Dodge, IA 50501
Phone
(515) 576-8151
Fax
(515) 576-5670
NPI assigned
Nov 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 6251 IA Primary

Addresses

Primary practice location

1611 First Ave North
Fort Dodge, IA 50501

Mailing address

1611 First Ave North
Fort Dodge, IA 50501
Phone (515) 576-8151

Other identifiers 1

IdentifierTypeStateIssuer
0143495MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20041123001142 IA Practitioner - Oral Surgery 0840255337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
University of Nebraska College of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1611 1St Ave N
Fort Dodge, IA 50501-4253
Phone (515) 576-8151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6251IAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. R. Bruce Cochrane DDS, PC Periodontics Past Accepting new patients
Dr. R. Bruce Cochrane DDS, PC Periodontics Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144309725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 FIRST AVE NORTH",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "50501",
            "telephone_number": "515-576-8151",
            "fax_number": "515-576-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 FIRST AVE NORTH",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "50501",
            "telephone_number": "515-576-8151",
            "fax_number": "515-576-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCHRANE",
        "first_name": "ROBERT",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IA",
            "license": "6251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0143495",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

Verify at the official NPI Registry.