Individual provider Active NPI

Tanner Cook, PA-C, MBA

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1841887718
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1923 South Utica Avenue
Siegfried Tower, 4TH Floor
Tulsa, OK 74104-6520
Phone
(505) 918-8388
NPI assigned
Dec 28, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1923 South Utica Avenue
Siegfried Tower, 4TH Floor
Tulsa, OK 74104-6520

Mailing address

1923 South Utica Avenue
Siegfried Tower, 4TH Floor
Tulsa, OK 74104-6520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230626002365 OK Practitioner - Physician Assistant 7012375827 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians
Usacs Observation Medicine Services of Oklahoma, LLCGroup PAC ID 9931562956, 203 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071

300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone (918) 684-2101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Physician Assistant

State licenses

LicenseStateTypeSpecialty
5047OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. CurrentSince Jun 26, 2023 Accepting new patients
Usacs Critical Care Medicine of Oklahoma, LLC CurrentSince Jan 1, 2025 Accepting new patients
St. John Physicians, Inc CurrentSince Jun 26, 2023 Accepting new patients
St. John Physicians, Inc CurrentSince Jun 26, 2023 Accepting new patients
Usacs Observation Medicine Services of Oklahoma, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1923 S Utica Ave
Fl 4
Tulsa, OK 74104
Phone (918) 748-7650

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1841887718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SOUTH UTICA AVENUE",
            "address_2": "SIEGFRIED TOWER, 4TH FLOOR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 SOUTH UTICA AVENUE",
            "address_2": "SIEGFRIED TOWER, 4TH FLOOR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "505-918-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "TANNER",
        "credential": "PA-C, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-28",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.