Active NPI
John Richard Cook, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Boone, IA
National Provider Identifier
1790740488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 19888
- Practice address
- 1015 Union St Ste 110
Boone, IA 50036-4821 - Phone
- (515) 433-8173
- Fax
- (515) 433-0696
- NPI assigned
- Apr 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 19888 | IA | Primary |
Addresses
Primary practice location
1015 Union St Ste 110
Boone, IA 50036-4821
Mailing address
PO Box 542
Boone, IA 50036-0542
Phone (515) 433-8173
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 316794 | Other | IA | BLUE CROSS/BLUE SHIELD |
| 0161281 | Medicaid | IA | |
| 3184 | Other | IA | MIDLANDS CHOICE |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19888 | IA | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boone County Hospital | Past | Accepting new patients | |
| Boone County Hospital | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Critical Access Hospital
- Boone, IA
- NPI 1467434225
-
- Registered Nurse
- Boone, IA
- NPI 1619017282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1790740488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 542",
"city": "BOONE",
"state": "IA",
"postal_code": "500360542",
"telephone_number": "515-433-8173",
"fax_number": "515-433-0696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 UNION ST STE 110",
"city": "BOONE",
"state": "IA",
"postal_code": "500364821",
"telephone_number": "515-433-8173",
"fax_number": "515-433-0696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "JOHN",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-18",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IA",
"license": "19888",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "316794",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0161281",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "3184",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boone, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.