Individual provider Active NPI

Raymond Wesley Cooper Jr., O.T.

  • Occupational Therapist
  • Bel Air, MD
National Provider Identifier
1073579744
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
02327 Issued in MD
Practice address
1131 Baltimore Pike
Bel Air, MD 21014-5132
Phone
(410) 838-6070
Fax
(410) 838-6961
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 02327 MD Primary

Addresses

Primary practice location

1131 Baltimore Pike
Bel Air, MD 21014-5132

Mailing address

807A S Union Ave
Havre de Grace, MD 21078-3610
Phone (410) 939-2262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060221000703 MD Practitioner - Occupational Therapist in Private Practice 6800802331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smith and Prothero Physical Therapy LLCGroup PAC ID 9335155860, 9 clinicians

Practice addresses (Care Compare)

1131 Baltimore Pike
Suite B
Bel Air, MD 21014-5132
Phone (410) 838-6070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02327MDMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Smith & Prothero Physical Therapy LLC Occupational Therapist CurrentSince Nov 10, 2019 Accepting new patients
Smith & Prothero Physical Therapy LLC CurrentSince Feb 1, 2006 Accepting new patients

Locations

1131 Baltimore Pike
Ste B
Bel Air, MD 21014
Phone (410) 838-6070

1131 Bel Air Rd
Bel Air, MD 21014
Phone (410) 838-6070

807 S Union Ave
#A
Havre de Grace, MD 21078
Phone (410) 939-2262

807A S Union Ave
Hvre de Grace, MD 21078
Phone (410) 939-2262

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1073579744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807A S UNION AVE",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783610",
            "telephone_number": "410-939-2262",
            "fax_number": "410-939-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BALTIMORE PIKE",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210145132",
            "telephone_number": "410-838-6070",
            "fax_number": "410-838-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "RAYMOND",
        "middle_name": "WESLEY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "02327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.