SCOTT A. COOPER (NPI# 1003999228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003999228 |
| Entity Type | Individual |
| Full Name | SCOTT A. COOPER |
| Credential | M.D. |
| Practice Address |
405 W Jackson St Memorial Hospital Carbondale IL 62901-1462 |
| Practice Telephone | 6185490721 |
| Practice Fax Number | 6185290449 |
| Mailing Telephone | 6185490721 |
| Mailing Fax Number | 6185290449 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 036064861 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036064861 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 530 Park Ave E, Princeton, IL 61356 | 8158752811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588692974 | Scott Cooper | Podiatrist | 30 Dekalb Ave, 2nd Floor, Brooklyn, NY 11201-5314 | 2006-06-28 |
| 1285670687 | Scott Bryson Cooper | Internal Medicine | James H. Quillen/vamc, Corner of Sydney and Lamont, Johnson City, TN 37684 | 2006-06-22 |
| 1902878440 | Scott Cooper | Orthopaedic Surgery | 1000 S 52nd Street, Rogers, AR 72758 | 2006-02-07 |
| 1598743262 | Scott B Cooper | Chiropractor | 2390 W Main St Ste E, Medford, OR 97501-2393 | 2006-01-04 |
| 1184142879 | Scott Cooper | Physician Assistant | 1310 E Dimond Blvd Ste 1, Anchorage, AK 99515-2031 | 2017-09-01 |
| 1306366471 | Scott Cooper | Family Medicine | 1126 S Clifton Ave, Wichita, KS 67218-2913 | 2017-06-21 |
| 1093189722 | Scott Lester Cooper | Counselor | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2015-11-18 |
| 1427335348 | Scott Allen Cooper | Physician Assistant | 731 12th Ave Nw, Ardmore, OK 73401-5761 | 2011-11-06 |
| 1144508482 | Scott Cooper | Pharmacist | 1745 Peachtree Rd Ne, Atlanta, GA 30309-2410 | 2011-08-03 |
| 1821275900 | Scott Thomas Cooper | Internal Medicine | 14540 Old Saint Augustine Rd, Suite 2207, Jacksonville, FL 32258-7418 | 2008-01-30 |
| Street Address |
405 W JACKSON ST MEMORIAL HOSPITAL |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194726851 | Shahriar Bozorgzadeh | Emergency Medicine | 405 W Jackson St, Carbondale, IL 62901-1462 | 2005-08-03 |
| 1568071132 | Cynthia Sue Davis | Nurse Practitioner | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-07-29 |
| 1629686019 | Dianne Zuasula Catolos | Physical Therapist | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-07-21 |
| 1871113696 | Summer R Black | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-04-22 |
| 1871123067 | Hailee Elizabeth Bowlin | Nurse Practitioner | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-01-16 |
| 1972061737 | Briana Nichole Jones | Speech-Language Pathologist | 405 W Jackson St, Carbondale, IL 62901-1462 | 2019-03-11 |
| 1700362183 | John Grady Johnston Jr. | Registered Nurse | 405 W Jackson St, Carbondale, IL 62901 | 2018-07-18 |
| 1972099067 | Andrew Mcnally | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2018-07-02 |
| 1134610587 | Megan E Sims | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2018-05-22 |
| 1447749833 | Erika Diericx | Pharmacist | 405 W Jackson St, Carbondale, IL 62901-1462 | 2018-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790128817 | Integritas Emergency Physician Services, LLC | Emergency Medicine | 2250 N. Illinois Ave, Carbondale, IL 62901 | 2013-04-08 |
| 1316193543 | Asim K Jaffer | Emergency Medicine | 405 West Jackson, Memorial Hospital of Carbondale Ed, Carbondale, IL 62901 | 2008-08-07 |
| 1225295116 | Melba Margaret Taylor | Emergency Medicine | 405 West Jackson Street, Memorial Hospital of Carbondale Emergency Services, Carbondale, IL 62901 | 2008-05-19 |
| 1467512848 | Michael Rafati | Emergency Medicine | 3114 W Sunset Dr, Carbondale, IL 62901-1951 | 2006-12-08 |
| 1194726851 | Shahriar Bozorgzadeh | Emergency Medicine | 405 W Jackson St, Carbondale, IL 62901-1462 | 2005-08-03 |
| 1861946626 | Granite City Emergency Medicine Providers LLC | Emergency Medicine | 2250 N Illinois Ave, Carbondale, IL 62901-5612 | 2016-08-10 |
| 1639522998 | Ifeanyichukwu Alex Anoka | Emergency Medicine | 405 W Jackson St, Carbondale, IL 62901 | 2016-07-21 |
| 1720432115 | Mutaz Musa | Emergency Medicine | 405 W Jackson St, Carbondale, IL 62901-1462 | 2016-04-21 |
| 1992168702 | Oluwatosin Aluko-olokun | Emergency Medicine | 405 W Jackson St, Carbondale, IL 62901-1462 | 2016-03-30 |
| 1780024232 | Yonatan Negasi Yohannes | Emergency Medicine | 405 W Jackson St, Carbondale, IL 62901-1462 | 2013-06-28 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.