Cooper Clinic, PA

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

MC-0254 Issued in AR

Legal business name

COOPER CLINIC, PA

Practice address

6801 Rogers Ave
Fort Smith, AR 72903-4067

Phone

(479) 274-2004

Fax

(479) 274-2024

NPI assigned

Oct 25, 2006

Last updated

Aug 28, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa G Astin

Title

Director, Business Services

Phone

(479) 274-2024

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440720000000",
    "number": "1073698478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3528",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729133528",
            "telephone_number": "479-274-2004",
            "fax_number": "479-274-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034067",
            "telephone_number": "479-274-2004",
            "fax_number": "479-274-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-08-28",
        "status": "A",
        "authorized_official_last_name": "ASTIN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR, BUSINESS SERVICES",
        "authorized_official_telephone_number": "479-274-2024"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AR",
            "license": "MC-0254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110161709",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "690001634",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cooper Clinic PA
• Cooper Clinic PA
• Cooper Clinic PA
• Cooper Clinic PA
• Cooper Clinic, P.a.
• Cooper Clinic, PA
• Cooper Clinic, PA
• Cooper Clinic, PA
• Cooper Clinic, PA
• Cooper Clinic, PA

• Clinical Medical Laboratory in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Clinical Medical Laboratory in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.