KENNETH ROBERT COOK (NURSE PRACTITIONER) – Family Nurse Practitioner, NPI 1831161397

KENNETH ROBERT COOK (NURSE PRACTITIONER) is a healthcare provider. based in Tupelo, Mississippi. specializing in NURSE PRACTITIONER. They hold the professional credentials NURSE PRACTITIONER. They hold a License No. R867598 (MS). The NPI Number for KENNETH ROBERT COOK (NURSE PRACTITIONER) is 1831161397

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
KENNETH ROBERT COOK (NURSE PRACTITIONER)
NPI
1831161397
Phone
(662) 377-4685
Address
450 E PRESIDENT AVE
Enumeration Date
7 February 2006
Last Update Date
30 October 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6623775400
Graduation Year
1997 (29 years ago)
PAC ID
1456480060
Group Practice PAC ID
6103736665
Professional Enrollment ID
I20100519000902
Address ID
MS388014904TU844XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,566 NURSE PRACTITIONER in MS

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Provider Addresses for KENNETH ROBERT COOK (NURSE PRACTITIONER)

  • President Avenue, Lee Acres, Tupelo, Lee County, Mississippi, 38801, United States

    TUPELO, MS 388015599

    Phone: (662) 377-4685

    Fax: (662) 377-2755

    Type: Mailing

  • 410, Council Circle, Tupelo, Lee County, Mississippi, 38801, United States

    TUPELO, MS 388014938

    Phone: (662) 377-5400

    Fax: (662) 377-5415

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-05-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100519000902INurse PractitionerMSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes332263$0
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg26598$0
96372Injection of drug or substance under skin or into muscle151132$0
99214Established patient office or other outpatient visit, 30-39 minutes121113$0
J1885Injection, ketorolac tromethamine, per 15 mg9023$0
View full utilization report →

Insurance plans in this area (ZIP 38801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103736665View full group profile

Reviews

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Frequently asked questions

How do I look up KENNETH ROBERT COOK (NURSE PRACTITIONER) by NPI?
Use NPI 1831161397 when you need to reference KENNETH ROBERT COOK (NURSE PRACTITIONER) in forms, claims, or directories.
Is KENNETH ROBERT COOK (NURSE PRACTITIONER)'s NPI currently valid?
The extract we use shows KENNETH ROBERT COOK (NURSE PRACTITIONER) as active.
Does KENNETH ROBERT COOK (NURSE PRACTITIONER) list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for KENNETH ROBERT COOK (NURSE PRACTITIONER). Clinical services aligned with this taxonomy classification.
Does KENNETH ROBERT COOK (NURSE PRACTITIONER) practice in Mississippi?
You will see Tupelo, Mississippi on file for KENNETH ROBERT COOK (NURSE PRACTITIONER) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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