Active NPI
Jeffrey Alan Cook, O.D.
- Optometrist
- Sidney, NE
National Provider Identifier
1366436701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 892
- Practice address
- 900 Pine St
Sidney, NE 69162-2241 - Phone
- (308) 254-4041
- Fax
- (308) 254-3718
- NPI assigned
- Aug 31, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 892 | NE | |
| Pediatric Optometrist | 152WP0200X | 892 | NE | |
| Sports Vision Optometrist | 152WS0006X | 892 | NE | |
| Vision Therapy Optometrist | 152WV0400X | 892 | NE | |
| Occupational Vision Optometrist | 152WX0102X | 892 | NE | |
| Optometrist | 152W00000X | 892 | NE | Primary |
Addresses
Primary practice location
900 Pine St
Sidney, NE 69162-2241
Mailing address
PO Box 61
Sidney, NE 69162-0061
Phone (308) 254-4041
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 245327 | Other | NE | MIDLANDS CHOICE PROVIDER |
| 37094 | Other | NE | BCBS PROVIDER NUMBER |
| 10025341000 | Medicaid | NE | |
| 410025992 | Other | NE | UNITED HEALTH CARE |
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 |
|---|---|---|---|
| 892 | NE | MD | Family Medicine Physician |
Interoperability endpoints
- jeffreycook@sidney-vision-clinic.direct.kno2fy.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582070400000",
"number": "1366436701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 61",
"city": "SIDNEY",
"state": "NE",
"postal_code": "691620061",
"telephone_number": "308-254-4041",
"fax_number": "308-254-3718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 PINE ST",
"city": "SIDNEY",
"state": "NE",
"postal_code": "691622241",
"telephone_number": "308-254-4041",
"fax_number": "308-254-3718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "JEFFREY",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-31",
"last_updated": "2020-02-19",
"certification_date": "2020-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "NE",
"license": "892",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "NE",
"license": "892",
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "",
"desc": "Optometrist, Sports Vision",
"state": "NE",
"license": "892",
"primary": false
},
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "NE",
"license": "892",
"primary": false
},
{
"code": "152WX0102X",
"taxonomy_group": "",
"desc": "Optometrist, Occupational Vision",
"state": "NE",
"license": "892",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NE",
"license": "892",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE PROVIDER",
"identifier": "245327",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "37094",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025341000",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "410025992",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sidney, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.