Individual provider Active NPI

Gregory Gerard Cook, D.P.M.

  • Foot Surgery Podiatrist
  • Sun City Center, FL
National Provider Identifier
1174711204
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
PO0002468 Issued in FL
Practice address
4040 Upper Creek Dr Ste 106
Sun City Center, FL 33573-6844
Phone
(813) 645-1993
Fax
(727) 824-5132
NPI assigned
Oct 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X PO0002468 FL Primary

Addresses

Primary practice location

4040 Upper Creek Dr Ste 106
Sun City Center, FL 33573-6844

Mailing address

4040 Upper Creek Dr Ste 106
Sun City Center, FL 33573-6844
Phone (727) 824-5100

Other practice location 1

7926 W Hillsborough Ave Ste G
Tampa, FL 33615-4600
Phone (813) 645-1993

Other practice location 2

318 Eighth Avenue North
St. Petersburg, FL 33701
Phone (727) 824-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100512000873 FL Practitioner - Podiatry 8022146026 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO0002468FLMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fit Feet for Life, Inc. Foot Surgery CurrentSince Sep 7, 2021 Accepting new patients

Locations

4040 Upper Creek Dr
Ste 106
Sun City Ctr, FL 33573
Phone (727) 824-5100

7926 W Hillsborough Ave
Ste G
Tampa, FL 33615
Phone (813) 886-9180

7926 W Hillsborough Ave
Twn North Cntry, FL 33615
Phone (813) 822-3573

Interoperability endpoints

  • Direct secure messaging: gregory.cook.1@13000.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/13000/brand/1/csg/1/fhir/r4

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": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1174711204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 UPPER CREEK DR STE 106",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736844",
            "telephone_number": "727-824-5100",
            "fax_number": "727-824-5132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 UPPER CREEK DR STE 106",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736844",
            "telephone_number": "813-645-1993",
            "fax_number": "727-824-5132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7926 W Hillsborough Ave Ste G",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336154600",
            "country_code": "US",
            "telephone_number": "813-645-1993",
            "fax_number": "727-824-5132",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "318 Eighth Avenue North",
            "address_purpose": "LOCATION",
            "city": "St. Petersburg",
            "state": "FL",
            "postal_code": "33701",
            "country_code": "US",
            "telephone_number": "727-824-5100",
            "fax_number": "727-824-5132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "GREGORY",
        "middle_name": "GERARD",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO0002468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City Center, FL

Sources for this page

Verify at the official NPI Registry.