Charles Ian Cooperberg, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

32098 Issued in NC

Practice address

4419 Ben Franklin Blvd
Durham, NC 27704-2147

Phone

(919) 477-3005

Fax

(919) 477-5526

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Chuck Cooperberg Other name

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Durham Nephrology Associates PAGroup PAC ID 3072589027, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• FMS Dialysis Services of Oxford Dialysis facility, Oxford, NC, CCN 342647
• FMS South Durham Dialysis Center Dialysis facility, Durham, NC, CCN 342680
• FMC - Freedom Lake Dialysis Unit Dialysis facility, Durham, NC, CCN 342538
• Duke Regional Hospital Hospital, Durham, NC, CCN 340155
• Granville Health Systems Hospital, Oxford, NC, CCN 340127

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.cooperberg@direct.dna.nchie.net
• Direct secure messaging: ccooperberg15268@direct.acumenmd.com

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.

• Durham Nephrology Associates PA

  • Nephrology Physician
  • Durham, NC
  • NPI 1962583203
  Medicare reassignment Care Compare group NPD Authorized official

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

• Bio-Medical Applications of North Carolina, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Oxford, NC
  • NPI 1447287065

  Dialysis facility

  Care Compare affiliation Name & address match
• Bio-Medical Applications of North Carolina, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Durham, NC
  • NPI 1518079334

  Dialysis facility

  Care Compare affiliation Name & address match
• Bio-Medical Applications of North Carolina, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Durham, NC
  • NPI 1710214648

  Dialysis facility

  Care Compare affiliation Name & address match
• Duke University Health System Inc

  • Clinical Medical Laboratory
  • Durham, NC
  • NPI 1689656480

  Hospital

  Care Compare affiliation
• Duke University Health System, Inc.

  • General Acute Care Hospital
  • Durham, NC
  • NPI 1871592113
  Care Compare affiliation
• Granville Health System

  • General Acute Care Hospital
  • Oxford, NC
  • NPI 1326061730
  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1073530655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 BEN FRANKLIN BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042147",
            "telephone_number": "919-477-3005",
            "fax_number": "919-477-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 BEN FRANKLIN BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042147",
            "telephone_number": "919-477-3005",
            "fax_number": "919-477-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPERBERG",
        "first_name": "CHARLES",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "32098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8924146",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHUCK",
            "last_name": "COOPERBERG",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ryan Andrew Cooper
• Taji Cooper
• Vaishali Cooper, PA-C
• Velma Edwards Cooper, DMD
• Zarydah Elizabeth Safiir Cooper
• Coordinated Health Services
• Coordinated Health Services, Inc.
• Heidi Cope, M.S.
• Matthew Warren Cope, M.D.
• Tyler Cope, ATC, DPT

• Nephrology Physician in Durham, NC
• Providers in Durham, NC by specialty
• Nephrology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.