KELLY COOPER (NPI# 1386191252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386191252 |
| Entity Type | Individual |
| Full Name | KELLY COOPER |
| Credential | D.D.S. |
| Practice Address |
221 3rd St W Bldg 1040 Jbsa Randolph TX 78150-4800 |
| Practice Telephone | 2106523301 |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2020-09-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
32365 | TX | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 151 Bodin Cir, Travis Afb, CA 945351801 | 7074237008 | |
| 224 W D.l. Ingram Ave, Bldg 1408, Cannon Afb, NM 88103 | 5757844041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396133641 | Kelly Cooper | Physical Therapy Assistant | 3200 North Elm Street, Greensboro, NC 27408 | 2015-01-08 |
| 1881992741 | Kelly Frances Cooper | Massage Therapist | 3324 W University Ave # 344, Gainesville, FL 32607-2540 | 2011-03-02 |
| 1265763098 | Kelly Marie Cooper | Massage Therapist | 25 Quail Hollow Rd, Fairview, NC 28730-8505 | 2010-01-19 |
| 1124628300 | Kelly M Cooper | Optometrist | 210 Marlboro Ave Ste 31, Easton, MD 21601-2767 | 2020-10-28 |
| 1255979787 | Kelly Cooper | Speech-Language Pathologist | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2019-12-16 |
| 1851945943 | Kelly Cooper | Counselor | 506 Grover St Ste 112, Lynden, WA 98264-1960 | 2019-07-28 |
| 1871063792 | Kelly Cooper | Counselor | 1455 Dixon Ave, Lafayette, CO 80026-8879 | 2018-12-04 |
| 1114411915 | Kelly Anne Cooper | Counselor | 5284 Adolfo Rd Ste 100, Camarillo, CA 93012-6790 | 2018-06-15 |
| 1316468820 | Kelly Ann Cooper | Nurse Practitioner | 401 E Chestnut St Unit 310, Louisville, KY 40202-5703 | 2017-07-06 |
| 1174945141 | Kelly A Cooper | Case Manager/Care Coordinator | 200 E Frazier Ave, Columbia, KY 42728-1915 | 2014-01-10 |
| Street Address |
221 3RD ST W BLDG 1040 |
| City | JBSA RANDOLPH |
| State | TX |
| Zip Code | 78150-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427042183 | Karen Ann Ryan-philpott | Pediatrics | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2005-09-08 |
| 1235695412 | Alexandra Schulte | General Practice | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2019-02-13 |
| 1225525926 | Kristyn Brooke Loggins | Pharmacist | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2018-04-18 |
| 1053831149 | Angelique Stacey Ann Forrester | Family Medicine | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2017-06-21 |
| 1770014383 | Daniel Stephen Catts | Pediatrics | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2017-03-24 |
| 1972974061 | Jeffery Rueben | Physician Assistant | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2015-10-14 |
| 1053787259 | Leanne Putnam | Nurse Practitioner | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2015-08-11 |
| 1780066035 | Karla Renise Ivy | Family Medicine | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2015-06-23 |
| 1427437151 | Jacqueline Gutierrez | Student in an Organized Health Care Education/Training Program | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2015-05-27 |
| 1699153486 | Andrew Grove | Dentist | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2015-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045833 | Erica Renae Guevara | Physician Assistant | 559 Medial Sq, 221 Third Street West Bldg. 1040, Jbsa-randolph Afb, TX 78150 | 2019-04-05 |
| 1457803868 | Emily Newman | Dietitian, Registered | 221 Third Street West, Bldg. 999 Ste 2, Joint Base San Antonio -randolph, TX 78150 | 2016-11-02 |
| 1922411677 | Amber Drewer | Military Health Care Provider | 3rd Street West Building 1040, Randolph Afb, TX 78150 | 2014-06-10 |
| 1144652975 | Josephine Kimberly Olsen | Family Medicine | 359 Mdos/mdg, Randolph Afb, TX 78150 | 2013-08-02 |
| 1609149681 | Lucky Lusterio | Preventive Medicine | 221 3rd St. W, Randolph Afb, TX 78150 | 2012-02-21 |
| 1417120569 | Joni Hodgson | General Practice | 221 3rd Street West, Jbsa Randolph, TX 78150 | 2008-04-09 |
| 1710095724 | Katherine Justen Adamson | Physician Assistant | 12th Medical Group, 221 3rd Street West, Randolph Air Force Base, TX 78150 | 2006-08-29 |
| 1811950090 | Lidia Stana Ilcus | Internal Medicine | 359 Mdg, 221 Third Street West, Randolph Afb, TX 78150 | 2006-04-10 |
| 1013970672 | David Hamilton | Social Worker | 12mdos/sgohf, Randolph Afb, TX 78150 | 2006-04-06 |
| 1962465526 | Robert Allan Briggs | Physical Therapist | Randolph Afb Clinic, 221 3rd St W, Randolph Afb, TX 78150 | 2006-04-06 |
| Find all providers in zip 78150 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699153486 | Andrew Grove | Dentist | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2015-05-12 |
| 1780920819 | Rachael L Parrish | Dentist | 221 3rd St W, Jbsa Randolph, TX 78150 | 2012-12-18 |
| 1417926452 | Federico Capnay Aquino Jr. | Dentist | 221 3rd St W, Jbsa Randolph, TX 78150-4801 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447537 | Azle Cube Smiles Pllc | Dentist | 100 Park Plc Ste 224, Azle, TX 76020 | 2020-11-04 |
| 1548860257 | Emeka Abazie Dds Pa | Dentist | 1001 N. Beckley, Suite 304, Desoto, TX 75115 | 2020-10-30 |
| 1699375543 | Long Family Dental | Dentist | 4470 E Highway 287 Ste 1200, Midlothian, TX 76065-7556 | 2020-10-29 |
| 1548860992 | Vequinox Pllc | Dentist | 2605 N Shary Rd, Mission, TX 78574-3221 | 2020-10-27 |
| 1952900466 | Gwendolyn Kines-mcleod Dds,pllc | Dentist | 401 N Ann St Ste B, Terrell, TX 75160-2549 | 2020-10-26 |
| 1609476183 | Texas Saas Pa | Dentist | 3839 Mckinney Ave Ste 130, Dallas, TX 75204-1489 | 2020-10-26 |
| 1295334803 | Jpm Dental of Spring | Dentist | 7312 Louetta Rd Ste B119, Spring, TX 77379-6176 | 2020-10-23 |
| 1750980025 | Neda Hani Tabaei Zavareh | Dentist | 10900 Twisted Elm Dr, Austin, TX 78726-2369 | 2020-10-19 |
| 1710586029 | Whitestone Dental Center Pllc | Dentist | 500 W Whitestone Blvd Ste 102, Cedar Park, TX 78613-2271 | 2020-10-19 |
| 1841899226 | Calvin Eastwood Dds Pllc | Dentist | 3088 Basswood Blvd # 150, Fort Worth, TX 76137-1676 | 2020-10-18 |
| Find all providers with the same taxonomy | ||||
| City | JBSA RANDOLPH |
| Zip Code | 78150 |
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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.