Individual provider Active NPI

Hobart Shay Cook, DC

  • Chiropractor
  • Wilmington, NC
National Provider Identifier
1841292513
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2705 Issued in NC
Practice address
2307 N College Rd
Wilmington, NC 28405-6427
Phone
(910) 392-1488
Fax
(910) 392-1489
NPI assigned
Aug 12, 2005
Last updated
Apr 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2705 NC Primary

Addresses

Primary practice location

2307 N College Rd
Wilmington, NC 28405-6427

Mailing address

2595 S 17TH St
Wilmington, NC 28401-7765
Phone (910) 791-2788

Other identifiers 1

IdentifierTypeStateIssuer
890841MMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100811000250 NC Practitioner - Chiropractic 2365576451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1999
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

2595 S 17TH St
Wilmington, NC 28401-7748
Phone (910) 791-2788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2705NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Healthcare Centers PC Chiropractor CurrentSince Jul 1, 2002 Accepting new patients
Southeastern Healthcare Centers PC Chiropractor Current Accepting new patients
Southeastern Healthcare Center PC Chiropractor CurrentSince Jul 1, 2002 Accepting new patients

Locations

110 Village Rd NE
Ste D
Leland, NC 28451
Phone (910) 371-1000

4501 Main St
Ste 2
Shallotte, NC 28470
Phone (910) 754-5678

2307 N College Rd
Wilmington, NC 28405
Phone (910) 392-1488

2595 S 17th St
Wilmington, NC 28401
Phone (910) 392-1252

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1841292513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017765",
            "telephone_number": "910-791-2788",
            "fax_number": "910-791-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 N COLLEGE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284056427",
            "telephone_number": "910-392-1488",
            "fax_number": "910-392-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "HOBART",
        "middle_name": "SHAY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890841M",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.