Individual provider Active NPI

Derek Adam Cook, CRNA

  • Certified Registered Nurse Anesthetist
  • New Orleans, LA
National Provider Identifier
1235161910
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN085217 Issued in LA
Practice address
200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone
(504) 896-9456
Fax
(504) 894-5168
NPI assigned
Jul 6, 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
Certified Registered Nurse Anesthetist 367500000X RN085217 LA Primary

Addresses

Primary practice location

200 Henry Clay Ave
New Orleans, LA 70118-5720

Mailing address

500 Helios Ave
Metairie, LA 70005-3244
Phone (504) 218-5929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050505000139 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365482775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Anesthesia CorporationGroup PAC ID 0446152862, 281 clinicians

Practice addresses (Care Compare)

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 613-0711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN085217LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Anesthesia Corporation CurrentSince Jan 24, 2005 Accepting new patients

Locations

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

5620 Read Blvd
New Orleans, LA 70127
Phone (504) 241-2664

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, 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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235161910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HELIOS AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700053244",
            "telephone_number": "504-218-5929",
            "fax_number": "504-894-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-896-9456",
            "fax_number": "504-894-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "DEREK",
        "middle_name": "ADAM",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN085217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.