Ryan Cooper, CCAR

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

2236 E Mitchell Rd Ste 5
Petoskey, MI 49770-9604

Phone

(313) 475-5112

NPI assigned

Mar 1, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Harbor Hall, Inc.

  • Family Medicine Physician
  • Petoskey, MI
  • NPI 1851865638
  NPD (past)
• Harbor Hall, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Petoskey, MI
  • NPI 1962551648
  NPD (past)

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1083471544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 EMMET ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702910",
            "telephone_number": "231-347-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 E MITCHELL RD STE 5",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709604",
            "telephone_number": "313-475-5112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Rush St",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497702920",
            "country_code": "US",
            "telephone_number": "231-347-5511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "704 Emmet St",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497702910",
            "country_code": "US",
            "telephone_number": "231-347-5511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 rush street",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497702920",
            "country_code": "US",
            "telephone_number": "231-347-5511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "520 N Main St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Cheboygan",
            "state": "MI",
            "postal_code": "497211162",
            "country_code": "US",
            "telephone_number": "231-597-9234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "RYAN",
        "credential": "CCAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-01",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Collective Impact Services LLC
• Anna Collins, LMSW
• Irene F Connolly, M.D.
• Danielle Nicole Cook, PA-C
• Rachel Cook
• Elena Catherine Coppola, D.O.
• Blake Gregory Corbin, PHARMD
• Nicholas James Coriasso, DO
• Adriane Lynn Corlew
• Brian Cornett, LLMSW

• Peer Specialist in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Peer Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.