Individual provider Active NPI

Joseph Benjamin Cooper, MD

  • Family Medicine Physician
  • Sandpoint, ID
National Provider Identifier
1063941383
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MC-2534 Issued in ID
Practice address
1218 N Division Ave Ste 208
Sandpoint, ID 83864-5054
Phone
(208) 263-3091
Fax
(208) 263-3147
NPI assigned
Jun 8, 2017
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MC-2534 ID
Family Medicine Physician 207Q00000X MC-2534 ID Primary
Hospitalist Physician 208M00000X MC-2534 ID

Addresses

Primary practice location

1218 N Division Ave Ste 208
Sandpoint, ID 83864-5054

Mailing address

1218 N Division Ave Ste 208
Sandpoint, ID 83864-5054
Phone (208) 263-3091

Other practice location 1

551 Highland Dr
Arco, ID 83213-5003
Phone (208) 252-7654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 2, 2025 through Jul 2, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MC-2534IDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grant County Public Hospital District 2 Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: joseph.cooper.1@11894.direct.athenahealth.com
  • Direct secure messaging: joseph.cooper.1@15048.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1063941383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 N DIVISION AVE STE 208",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838645054",
            "telephone_number": "208-263-3091",
            "fax_number": "208-263-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 N DIVISION AVE STE 208",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838645054",
            "telephone_number": "208-263-3091",
            "fax_number": "208-263-3147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "551 Highland Dr",
            "address_purpose": "LOCATION",
            "city": "Arco",
            "state": "ID",
            "postal_code": "832135003",
            "country_code": "US",
            "telephone_number": "208-252-7654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JOSEPH",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "MC-2534",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MC-2534",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ID",
            "license": "MC-2534",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandpoint, ID

Sources for this page

Verify at the official NPI Registry.