Individual provider Active NPI

Gerald B Cobb, M.D.

  • Emergency Medicine Physician
  • Conroe, TX
National Provider Identifier
1174509574
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G3237 Issued in TX
Practice address
504 Medical Center Blvd
Conroe, TX 77304-2808
Phone
(409) 539-1111
Fax
(409) 788-8044
NPI assigned
Dec 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G3237 TX Primary

Addresses

Primary practice location

504 Medical Center Blvd
Conroe, TX 77304-2808

Mailing address

PO Box 200993
Houston, TX 77216-0993
Phone (281) 784-1111

Other identifiers 4

IdentifierTypeStateIssuer
131187008MedicaidTX
131187007MedicaidTX
8F9633OtherTXBCBSTX PROV NO
1174509574OtherTXTRICARE SOUTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Star Urgent Care Management Inc PastSince Jul 6, 2013 Accepting new patients
Medical Center Emergency Physicians PA Emergency Medicine Past Accepting new patients

Organizations & group practices 2

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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1174509574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200993",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772160993",
            "telephone_number": "281-784-1111",
            "fax_number": "281-784-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 MEDICAL CENTER BLVD",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042808",
            "telephone_number": "409-539-1111",
            "fax_number": "409-788-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "GERALD",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G3237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131187008",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131187007",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX PROV NO",
            "identifier": "8F9633",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SOUTH",
            "identifier": "1174509574",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.