Individual provider Active NPI

Thomas Tedford Cook, APRN

  • Primary Care Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1336627223
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R102398 Issued in OK
Practice address
5700 N Portland Ave Ste 102
Oklahoma City, OK 73112-1650
Phone
(405) 942-5513
NPI assigned
Aug 1, 2018
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R102398 OK Primary

Addresses

Primary practice location

5700 N Portland Ave Ste 102
Oklahoma City, OK 73112-1650

Mailing address

5700 N Portland Ave Ste 102
Oklahoma City, OK 73112-1650
Phone (405) 942-5513

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
I20190516001553 OK Practitioner - Nurse Practitioner 0749523652 Practice locations: Oklahoma City, OK

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R102398OKMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1336627223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 N PORTLAND AVE STE 102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731121650",
            "telephone_number": "405-942-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 N PORTLAND AVE STE 102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731121650",
            "telephone_number": "405-942-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "THOMAS",
        "middle_name": "TEDFORD",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OK",
            "license": "R102398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.