Jordan C Cook, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

DO221863 Issued in OR

Practice address

21 Hayden Bridge Way
Springfield, OR 97477-1305

Phone

(541) 600-2017

Fax

(541) 225-4864

NPI assigned

Apr 27, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MT, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dermatology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evergreen Dermatology, LLCGroup PAC ID 0244618148, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.14 of 100Reported as group

Quality

82.27

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Evergreen Dermatology LLC

  • Dermatology Physician
  • Springfield, OR
  • NPI 1477207272
  Medicare reassignment Care Compare group NPD
• Highline Dermatology & Skin Cancer

  • Physician Assistant
  • Kalispell, MT
  • NPI 1558831289

  Dermatology

  Medicare reassignment NPD
• Glacier Dermatology PC

  • Dermatology Physician
  • Kalispell, MT
  • NPI 1407366545
  NPD (past)

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1588041719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HAYDEN BRIDGE WAY",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771305",
            "telephone_number": "541-600-2017",
            "fax_number": "541-225-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HAYDEN BRIDGE WAY",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771305",
            "telephone_number": "541-600-2017",
            "fax_number": "541-225-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "JORDAN",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "DO221863",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MT",
            "license": "87784",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Barrett Conner I
• Colleen Conroy, RMA
• Convergence Physical Therapy and Performance
• Lyla Conway, NP
• Charles Milton Cook, MD
• Laurie Cook, LCSW, QMHP
• Terri Cook, RPH
• Valerie Catherine Coon, MD
• Sarah Cooney
• Cathleen M Coontz, RN

• Dermatology Physician in Springfield, OR
• Providers in Springfield, OR by specialty
• Dermatology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.