Active NPI
Charles W Cook, MD
- Pediatric Adolescent Medicine Physician
- Oregon, OH
National Provider Identifier
1992703524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 35057280
- Practice address
- 1050 Isaac Streets Dr
#140
Oregon, OH 43616-3291 - Phone
- (419) 698-7722
- Fax
- (419) 698-7723
- NPI assigned
- Jul 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 35057280 | OH | Primary |
Addresses
Primary practice location
1050 Isaac Streets Dr
#140
Oregon, OH 43616-3291
Mailing address
4235 Secor Rd
Toledo, OH 43623-4231
Phone (419) 698-7722
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0711091 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35057280 | OH | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Toledo Clinic Incorporated | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Podiatrist
- Toledo, OH
- NPI 1457346462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308528000000",
"number": "1992703524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4235 SECOR RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436234231",
"telephone_number": "419-698-7722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 ISAAC STREETS DR",
"address_2": "#140",
"city": "OREGON",
"state": "OH",
"postal_code": "436163291",
"telephone_number": "419-698-7722",
"fax_number": "419-698-7723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "CHARLES",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-08",
"last_updated": "2011-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "OH",
"license": "35057280",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0711091",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oregon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.