Individual provider Active NPI

Jason Wave Cook, O.D.

  • Optometrist
  • Anniston, AL
National Provider Identifier
1972565802
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-932-TA-486 Issued in AL
Practice address
600 Leighton Ave
Anniston, AL 36207-5744
Phone
(256) 238-8718
Fax
(256) 238-8755
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-932-TA-486 AL Primary

Addresses

Primary practice location

600 Leighton Ave
Anniston, AL 36207-5744

Mailing address

600 Leighton Ave
Anniston, AL 36207-5744
Phone (256) 238-8718

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040618001052 AL Practitioner - Optometry 9032194618 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-932-TA-486ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jason W. Cook, OD, LLC Optometrist CurrentSince Aug 1, 2004 Accepting new patients
Robert G Carden Optometrist Past Accepting new patients

Locations

600 Leighton Ave
Anniston, AL 36207
Phone (256) 238-8718

1413 Rainbow Dr
Ste 1
Gadsden, AL 35901
Phone (256) 543-8886

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1972565802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 LEIGHTON AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362075744",
            "telephone_number": "256-238-8718",
            "fax_number": "256-238-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 LEIGHTON AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362075744",
            "telephone_number": "256-238-8718",
            "fax_number": "256-238-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "JASON",
        "middle_name": "WAVE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-932-TA-486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anniston, AL

Sources for this page

Verify at the official NPI Registry.