NPIMap

Individual provider Active NPI

William R. Cooper, MD

  • Internal Medicine Physician
  • Oconomowoc, WI
National Provider Identifier
1023078037
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
49183 Issued in WI
Practice address
1185 Corporate Center Dr Ste 175
Prohealth Care Medical Associates Inc.
Oconomowoc, WI 53066-4889
Phone
(262) 928-8400
NPI assigned
Mar 24, 2006
Last updated
Apr 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 49183 WI Primary

Addresses

Primary practice location

1185 Corporate Center Dr Ste 175
Prohealth Care Medical Associates Inc.
Oconomowoc, WI 53066-4889

Mailing address

1185 Corporate Center Dr Ste 175
Prohealth Care Medical Associates Inc.
Oconomowoc, WI 53066-4889
Phone (262) 928-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060817000516 WI Practitioner - Internal Medicine 3870575244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Wisconsin School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1185 Corporate Ctr Dr
Suite 175
Oconomowoc, WI 53066-4889
Phone (262) 928-8400

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49183WIMDInternal Medicine Physician
6367MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. Internal Medicine CurrentSince Aug 7, 2011 Accepting new patients
Prohealth Medical Group Inc Internal Medicine CurrentSince Aug 7, 2011 Accepting new patients
Lutheran Homes of Oconomowoc Inc. Past Accepting new patients
Prohealth Medical Group Inc Internal Medicine Past Accepting new patients

Locations

2750 Golf Rd
Delafield, WI 53018
Phone (262) 928-4900

1185 Corporate Center Dr
Ste 175
Oconomowoc, WI 53066
Phone (262) 928-6236

820 Summit Ave
Oconomowoc, WI 53066
Phone (262) 567-0223

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Interoperability endpoints

  • Direct secure messaging: wcooper15467@direct.phci.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Shorehaven Health and Rehabilitation CenterOconomowoc, WI, CCN 525560 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 27, 2024
Dec 5, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1023078037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 CORPORATE CENTER DR STE 175",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664889",
            "telephone_number": "262-928-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 CORPORATE CENTER DR STE 175",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664889",
            "telephone_number": "262-928-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "WILLIAM",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "49183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.