Active NPI
Joseph Benjamin Cooper, MD
- Family Medicine Physician
- Sandpoint, ID
National Provider Identifier
1063941383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MC-2534
- 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, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| MC-2534 | ID | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grant County Public Hospital District 2 | Past | Accepting new patients |
Interoperability endpoints
- joseph.cooper.1@11894.direct.athenahealth.com
- 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.
-
dba Quincy Valley Medical Center
- Emergency Medical Services (Emergency Medicine) Physician
- Quincy, WA
- NPI 1659445468
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.