Gene Cook Supports, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

GENE COOK SUPPORTS, LLC

Practice address

108 2ND Ave
Scottdale, PA 15683-2105

Phone

(724) 217-5479

Fax

(724) 220-5194

NPI assigned

May 18, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Eugene Thomas Cook Sr., OWNER/ CEO

Title

Owner/ Ceo

Phone

(724) 217-5479

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1902253057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 2ND AVE",
            "city": "SCOTTDALE",
            "state": "PA",
            "postal_code": "156832105",
            "telephone_number": "724-217-5479",
            "fax_number": "724-220-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 2ND AVE",
            "city": "SCOTTDALE",
            "state": "PA",
            "postal_code": "156832105",
            "telephone_number": "724-217-5479",
            "fax_number": "724-220-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENE COOK SUPPORTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER/ CEO",
        "authorized_official_telephone_number": "724-217-5479",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "OWNER/ CEO"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA DL",
            "identifier": "24117708",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSN",
            "identifier": "$$$$$$$$$",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPI",
            "identifier": "1028009370001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.