Stephen Larry Cook, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28929 Issued in NE

Practice address

60 MDG/Sgop
101 Bodin Circle
Travis Afb, CA 94535

Phone

(916) 561-7793

Fax

(916) 561-7566

NPI assigned

Jun 9, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1932512746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5342 DUDLEY BLVD",
            "city": "MCCLELLAN",
            "state": "CA",
            "postal_code": "956521012",
            "telephone_number": "707-423-3000",
            "fax_number": "916-561-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MDG/SGOP",
            "address_2": "101 BODIN CIRCLE",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "94535",
            "telephone_number": "916-561-7793",
            "fax_number": "916-561-7566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5342 Dudley Blvd",
            "address_purpose": "LOCATION",
            "city": "McClellan",
            "state": "CA",
            "postal_code": "956521012",
            "country_code": "US",
            "telephone_number": "707-423-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "STEPHEN",
        "middle_name": "LARRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-09",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "28929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Andrew Clark, M.D
• Kimberley W Coleman
• Katelynn Marie Collins, MD
• Erika Conklin, CADC
• Ryan Lee Cook
• James R Cooney, M.D.
• Holly Corcoran
• Kameryn Corcoran
• Steven Correa
• Grace Victoria Cortez, RN

• Family Medicine Physician in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.