NPIMap

Organization Active NPI

Dr. R. Bruce Cochrane DDS, PC

  • Periodontics
  • Spencer, IA
National Provider Identifier
1205975505
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
6251 Issued in IA
Legal business name
DR. R. BRUCE COCHRANE DDS, PC
Practice address
114 E 5TH St
Spencer, IA 51301-5011
Phone
(712) 262-9395
Fax
(712) 262-3717
NPI assigned
Feb 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jean M Hoover, RDA
Title
Office Manager
Phone
(515) 576-8151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 6251 IA Primary

Addresses

Primary practice location

114 E 5TH St
Spencer, IA 51301-5011

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1143495MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Dr R Bruce Cochrane DDS PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

114 E 5th St
Spencer, IA 51301
Phone (712) 262-9133

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205975505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 1ST AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014253",
            "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": "114 E 5TH ST",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513015011",
            "telephone_number": "712-262-9395",
            "fax_number": "712-262-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. R. BRUCE COCHRANE DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOOVER",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "515-576-8151",
        "authorized_official_credential": "RDA"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IA",
            "license": "6251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1143495",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.