COOPER CLINIC PA (NPI# 1366655623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366655623 |
| Entity Type | Organization |
| Organization Name | COOPER CLINIC PA |
| Practice Address |
1801 E Main St Charleston AR 72933-9254 |
| Mailing Address |
Po Box 3528 Fort Smith AR 72913-3528 |
| Practice Telephone | 4792742000 |
| Practice Fax Number | 4792742194 |
| Mailing Telephone | 4792742000 |
| Mailing Fax Number | 4792742194 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2015-10-20 |
| Authorized Official Name | CURTIS RALSTON (CEO) |
| Authorized Official Telephone | 4792742000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MC-0254 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 141318729 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245633692 | Cooper Clinic Pa | Family Medicine | 690 N Kennedy Ave Rm 1, Booneville, AR 72927-3240 | 2014-09-30 |
| 1508122250 | Cooper Clinic Pa | Family Medicine | 2000 E Wood St Rm 1, Paris, AR 72855-2621 | 2012-04-06 |
| 1609898311 | Cooper Clinic Pa | Clinic/Center | 7306 Rogers Ave, Fort Smith, AR 72903-4164 | 2006-07-24 |
| 1588117519 | Cooper Clinic Pa | Physical Therapist | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2016-07-26 |
| 1841546785 | Cooper Clinic Pa | Podiatrist | 7306 Rogers Ave, Fort Smith, AR 72903-4164 | 2012-07-30 |
| 1063768901 | Cooper Clinic Pa | Podiatrist | 5004 S U St, Fort Smith, AR 72903-3600 | 2012-07-30 |
| 1710214010 | Cooper Clinic Pa | Podiatrist | 600 S 21st St, Fort Smith, AR 72901-3915 | 2009-11-06 |
| 1194911370 | Cooper Clinic Pa | Audiologist | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2007-09-20 |
| 1376739557 | Cooper Clinic Pa | Optometrist | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2007-09-20 |
| 1700099074 | Cooper Clinic Pa | Pediatrics | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2007-05-07 |
| Street Address |
1801 E MAIN ST |
| City | CHARLESTON |
| State | AR |
| Zip Code | 72933-9254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427070606 | Jason D Richey | Family Medicine | 1801 E Main St, Charleston, AR 72933-9254 | 2006-07-24 |
| 1922014521 | Cooper Clinic, Pa | Clinic/Center | 1801 E Main St, Charleston, AR 72933-9254 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891291290 | Damon Mark Mckenzie | Counselor | 107 S. Hancock, Charleston, AR 72933 | 2018-04-04 |
| 1700262375 | Lacey J Parker | Pharmacist | 621 East Main St, Charleston, AR 72933 | 2015-08-06 |
| 1306222872 | Courtney Houston | Pharmacist | 621 E Main Street, Charleston, AR 72933 | 2015-08-06 |
| 1518138478 | Sparks Regional Medical Center | Durable Medical Equipment & Medical Supplies | 17 So. Logan St., Charleston, AR 72933 | 2008-03-19 |
| 1356568562 | Tammy L Myers | Speech-Language Pathologist | 500 S Greenwood, Charleston, AR 72933 | 2007-04-19 |
| 1942427562 | City of Charleston Supt of Schools District 9 | Psychologist | 125 West Main Street, Charleston, AR 72933 | 2007-04-18 |
| 1376685107 | Stephanie Sharp | Speech-Language Pathologist | 9300 East County Line Road, Charleston, AR 72933 | 2007-02-12 |
| 1063507861 | Medisav Homecare Pharmacies Inc. | Pharmacy | 621 E Main, Charleston, AR 72933 | 2006-10-04 |
| 1447354014 | Sparks Medical Foundation | Durable Medical Equipment & Medical Supplies | 17 S. Logan St., Charleston, AR 72933 | 2006-09-12 |
| 1508853466 | Timbi D West | Nurse Practitioner | 1006 E Main Street, Charleston, AR 72933 | 2005-10-05 |
| Find all providers in zip 72933 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811595499 | Laura Coolidge | Family Medicine | 1528 Seacroft Rd, Charleston, SC 29412-8113 | 2020-10-15 |
| 1356954259 | Relymd Medical Group Wv, Pllc | Family Medicine | 1627 Quarrier St, Charleston, WV 25311-2124 | 2020-08-28 |
| 1922617950 | Fred E Hill | Family Medicine | 1033 Jervey Point Rd, Charleston, SC 29492-8372 | 2020-07-27 |
| 1093375222 | Valley Health Systems, Inc. | Family Medicine | 333 Laidley St Fl 6, Charleston, WV 25301-1614 | 2019-06-19 |
| 1427512201 | Catherine Courtney Slemp | Family Medicine | 350 Capitol St Rm 702, Charleston, WV 25301-1757 | 2019-01-25 |
| 1730677709 | Courtney Uhlar | Family Medicine | 169 Ashley Ave # Msc333, Charleston, SC 29425-9125 | 2018-04-25 |
| 1134617335 | Kelsey Rose Wilson | Family Medicine | 169 Ashley Ave. Room 202, Main Hospital Msc 333, Charleston, SC 29425-9125 | 2018-04-24 |
| 1659869816 | Anthony James Baglio | Family Medicine | 169 Ashley Avenue, Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2018-04-24 |
| 1396252219 | Lisa Ann Oshaughnessy Turnure | Family Medicine | 3 Sawgrass Rd Apt I6, Charleston, SC 29412-2579 | 2017-12-30 |
| 1720467525 | Sasha M. Perez | Family Medicine | 3030 Ashley Town Center Dr Ste 102a, Charleston, SC 29414 | 2015-05-26 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 72933 |
Please comment or provide details below to improve the information on COOPER CLINIC PA.
| 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.