Elizabeth Denise Cooper, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

528 Issued in WV

Practice address

200 Veterans Ave
Beckley, WV 25801-6444

Phone

(304) 255-2121

NPI assigned

Jan 12, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Elizabeth Denise Johnson Former name

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Wvva Health Care Alliance, PC

  • Internal Medicine Physician
  • Low Moor, VA
  • NPI 1255371993

  WV

  Medicare reassignment

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1073818795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VETERANS AVE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016444",
            "telephone_number": "304-255-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VETERANS AVE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016444",
            "telephone_number": "304-255-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ELIZABETH",
        "middle_name": "DENISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01530",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "JOHNSON",
            "middle_name": "DENISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Miranda Cook
• Riyann Cook
• Zachary T Cook
• Taylor Cooke
• Cooper Medical PLLC
• Hannah Cooper
• Joseph Anderson Cooper, PA-C
• Michael Cooper
• Ashley Copolo, PA-C
• Ella L Coppola

• Physician Assistant in Beckley, WV
• Providers in Beckley, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.