TYSON RANDALL COOK (NP) – Family Medicine Physician, NPI 1174250997

TYSON RANDALL COOK (NP) is a healthcare provider. based in Clinton, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 11096351-4405 (UT). The NPI Number for TYSON RANDALL COOK (NP) is 1174250997

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
TYSON RANDALL COOK (NP)
NPI
1174250997
Phone
(801) 678-1931
Address
2489 W 840 N
Enumeration Date
2 August 2022
Last Update Date
2 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8015436750
Graduation Year
2022 (4 years ago)
PAC ID
7517332711
Group Practice PAC ID
1850209420
Professional Enrollment ID
I20230330002599
Address ID
UT840413692LA201XXPKWY402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:3State licenses:1Digital endpointsOther names

2,657 NURSE PRACTITIONER in UT

Provider Addresses for TYSON RANDALL COOK (NP)

  • 2489 W 840 N

    CLINTON, UT 840159705

    Phone: (801) 678-1931

    Type: Mailing

  • 1915 W 5950 S

    ROY, UT 840671454

    Phone: (801) 387-8100

    Type: Location

  • PO BOX 27128

    SLC, UT 841270128

    Phone: (801) 543-6875

    Type: Mailing

  • 201 W LAYTON PKWY STE 1A

    LAYTON, UT 840413692

    Phone: (801) 543-6875

    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: 2023-03-30

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
I20230330002599INurse PractitionerUTTBD

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 minutes10098$0
99214Established patient office or other outpatient visit, 30-39 minutes3535$0
81003Automated urinalysis test3030$0
71046X-ray of chest, 2 views2323$0
99203New patient office or other outpatient visit, 30-44 minutes2121$0
View full utilization report →

Insurance plans in this area (ZIP 84015)

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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: 1850209420View full group profile

Reviews

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Frequently asked questions

What is the standard ID for TYSON RANDALL COOK (NP) in the U.S.?
In the U.S., TYSON RANDALL COOK (NP) is identified by NPI 1174250997.
Is TYSON RANDALL COOK (NP) currently accepting referrals based on NPI status?
Registry metadata lists TYSON RANDALL COOK (NP) as active.
What type of care does TYSON RANDALL COOK (NP) provide?
TYSON RANDALL COOK (NP)'s profile centers on Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is TYSON RANDALL COOK (NP) tied to Clinton, Utah?
If you are local to Clinton, Utah, TYSON RANDALL COOK (NP) may be relevant to your search.
Can I export TYSON RANDALL COOK (NP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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