Active NPI
Christopher Evan Cook, OD
- Optometrist
- Buchanan, GA
National Provider Identifier
1215136296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT002396
- Practice address
- 402 Courthouse Square
Buchanan, GA 30113 - Phone
- (404) 432-5089
- NPI assigned
- Jul 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT002396 | GA | Primary |
Addresses
Primary practice location
402 Courthouse Square
Buchanan, GA 30113
Mailing address
402 Courthouse Square
Buchanan, GA 30113-0000
Phone (770) 646-9100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 610997099A | Medicaid | GA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT002396 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Villa Rica Eye Care | Optometrist | Current | Accepting new patients |
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.
-
- Optometrist
- Buchanan, GA
- NPI 1720215775
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214265600000",
"number": "1215136296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 COURTHOUSE SQUARE",
"city": "BUCHANAN",
"state": "GA",
"postal_code": "301130000",
"telephone_number": "770-646-9100",
"fax_number": "770-646-0007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 COURTHOUSE SQUARE",
"city": "BUCHANAN",
"state": "GA",
"postal_code": "30113",
"telephone_number": "404-432-5089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "CHRISTOPHER",
"middle_name": "EVAN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-11",
"last_updated": "2008-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "OPT002396",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "610997099A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Buchanan, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.