Active NPI
Brian W Cook, MD
- Emergency Medicine Physician
- Clearwater, FL
National Provider Identifier
1790727642
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(2) exclusion effective Apr 20, 2014.
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME0083573
- Practice address
- 2560 N McMullen Booth Rd
Ste B
Clearwater, FL 33761-4182 - Phone
- (727) 726-1962
- NPI assigned
- Jun 12, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | ME0083573 | FL | Primary |
Addresses
Primary practice location
2560 N McMullen Booth Rd
Ste B
Clearwater, FL 33761-4182
Mailing address
PO Box 17308
Clearwater, FL 33762-0308
Phone (904) 482-1070
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06039 | Other | FL | BLUE SHIELD OF FL |
| 264873300 | Medicaid | FL |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0083573 | FL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Em-I Medical Services, PA | Emergency Medicine | Past | Accepting new patients |
| Bay Area Emergency Physicians LLC | Emergency Medicine | Past | Accepting new patients |
| Palms of Pasadena Emergency Physicians LLC | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Clearwater, FL
- NPI 1164459095
-
- Emergency Medicine Physician
- Clearwater, FL
- NPI 1720268733
-
- Emergency Medicine Physician
- South Pasadena, FL
- NPI 1164436341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299801600000",
"number": "1790727642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 17308",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337620308",
"telephone_number": "904-482-1070",
"fax_number": "904-482-1077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2560 N MCMULLEN BOOTH RD",
"address_2": "STE B",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337614182",
"telephone_number": "727-726-1962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "BRIAN",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2011-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME0083573",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF FL",
"identifier": "06039",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "264873300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.