Darryl Bruce Cook, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

M4758 Issued in ID

Practice address

1151 Hospital Way BLDG a
Pocatello, ID 83201-2763

Phone

(208) 232-6616

Fax

(208) 232-6618

NPI assigned

Jul 24, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pocatello Health Services, LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1689802852
  NPD
• Pocatello Hospital LLC

  • Internal Medicine Physician
  • Pocatello, ID
  • NPI 1760610935
  NPD
• Endoscopy Center, LLC

  • Endoscopy Clinic/Center
  • Pocatello, ID
  • NPI 1770502767
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1972525111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4788",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054788",
            "telephone_number": "208-232-6616",
            "fax_number": "208-232-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 HOSPITAL WAY BLDG A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012763",
            "telephone_number": "208-232-6616",
            "fax_number": "208-232-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "DARRYL",
        "middle_name": "BRUCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ID",
            "license": "M4758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002802900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Shelton Conner Jr., MD
• Leslie D Conner, PA
• Scott P Conover, D.O.
• Consumer Care LLC
• Chace Cook, MD
• Roger A Cook, MD
• Stephanie Cook, MT
• Marty T. Cooke, LCPC
• Kapra Jade Cooley-Rieders
• Natalie A Cooper, LAT, ATC

• All providers in Pocatello, ID
• Gastroenterology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.