Individual provider Active NPI

Demi Reyd Cook, APRN

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1295259067
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
113268 Issued in OK
Practice address
1717 A South Utica
Tulsa, OK 74104
Phone
(918) 748-7557
Fax
(918) 403-0383
NPI assigned
Aug 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 113268 OK Primary

Addresses

Primary practice location

1717 A South Utica
Tulsa, OK 74104

Mailing address

1717 A South Utica
Tulsa, OK 74104
Phone (918) 748-7557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171005003371 OK Practitioner - Nurse Practitioner 7719252436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St John Urgent Care Clinics IncGroup PAC ID 5890898084, 29 clinicians

Practice addresses (Care Compare)

1717 S Utica Ave
Suite a
Tulsa, OK 74104-5346
Phone (918) 748-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
113268OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Oct 2, 2017 Accepting new patients
St. John Physicians, Inc. Current Accepting new patients
St John Urgent Care Clinics Inc CurrentSince Oct 2, 2017 Accepting new patients
Parkside, Inc. Past Accepting new patients

Locations

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1717 S Utica Ave
Ste A
Tulsa, OK 74104
Phone (918) 748-1300

Organizations & group practices 4

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": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1295259067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 A SOUTH UTICA",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-748-7557",
            "fax_number": "918-403-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 A SOUTH UTICA",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-748-7557",
            "fax_number": "918-403-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "DEMI",
        "middle_name": "REYD",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "113268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.