MEDICARE: JESSICA ANN COOK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	MD.45767	AL
2	2085R0202X	Diagnostic Radiology Physician	2026-01557	NC
3	2255A2300X	Athletic Trainer	4605	FL

General Provider Information

NPI Number	:	1437526225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA ANN COOK MD

Provider Business Mailing Address
First Line	:	ONE MEDICAL CENTER BOULEVARD
Second Line	:	DIVISION OF RADIOLOGIC SCIENCE
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	ONE MEDICAL CENTER BOULEVARD
Second Line	:	DIVISION OF RADIOLOGIC SCIENCE
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-0001
Country	:	US
Telephone Number	:	336-716-1066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2015
Last Update Date	:	05/26/2026

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