Individual provider Active NPI

Cooper Scott Manley, DO

  • Family Medicine Physician
  • Cordova, TN
National Provider Identifier
1053054239
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-19546 Issued in AR
Practice address
957 Bending Pine LN
Cordova, TN 38018-0438
Phone
(423) 664-3650
NPI assigned
Apr 15, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X E-19546 AR Primary

Addresses

Primary practice location

957 Bending Pine LN
Cordova, TN 38018-0438

Mailing address

957 Bending Pine LN
Cordova, TN 38018-0438
Phone (423) 664-3650

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250729001968 AR Practitioner - Family Practice 2860909488 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians
Newgen of Arkansas LLCGroup PAC ID 3779076591, 13 clinicians

Practice addresses (Care Compare)

1001 Towson Ave
Fort Smith, AR 72901-4921
Phone (479) 441-4000

1100 E Poplar St
Clarksville, AR 72830-4419
Phone (479) 754-5454

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-19546ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC CurrentSince Aug 1, 2025 Accepting new patients
Arkansas Emergency Staffing Solutions, Inc CurrentSince Nov 1, 2025 Accepting new patients
HCC of El Dorado LLC CurrentSince Jan 1, 2026 Accepting new patients
Ess of El Dorado, LLC CurrentSince Jan 1, 2026 Accepting new patients
Ouachita County Medical Center CurrentSince Dec 1, 2025 Accepting new patients
HCC of Magnolia LLC CurrentSince Jan 1, 2026 Accepting new patients
Ouachita County Medical Center CurrentSince Dec 1, 2025 Accepting new patients
Newgen of Arkansas LLC CurrentSince Nov 1, 2025 Accepting new patients
Emergency Staffing Solutions Region III CurrentSince Jan 1, 2026 Accepting new patients

Locations

1100 E Poplar St
Clarksville, AR 72830
Phone (479) 754-5393

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

638 California Ave SW
East Camden, AR 71701
Phone (870) 836-1000

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

101 Hospital Dr
Magnolia, AR 71753
Phone (870) 235-3000

211 Crawford Memorial Dr
Van Buren, AR 72956
Phone (479) 471-4300

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

Organizations & group practices 9

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

Hospital & facility affiliations 3

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": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1053054239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 BENDING PINE LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380180438",
            "telephone_number": "423-664-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "957 BENDING PINE LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380180438",
            "telephone_number": "423-664-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "COOPER",
        "middle_name": "SCOTT",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-15",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-19546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.