Individual provider Active NPI

John David Cooper, MD

  • Internal Medicine Physician
  • Fort Belvoir, VA
National Provider Identifier
1093211971
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2020-00247 Issued in NC
Practice address
9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Phone
(571) 231-3224
NPI assigned
Apr 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2020-00247 NC Primary

Addresses

Primary practice location

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285

Mailing address

8901 Rockville Pike
Bethesda, MD 20889-0001

Other practice location 1

8901 Wisconsin Ave
Bethesda, MD 20889-0004
Phone (301) 295-0196

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241024001305 NC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6507399961

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1093211971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 ROCKVILLE PIKE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-3224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208890004",
            "country_code": "US",
            "telephone_number": "301-295-0196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-01",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2020-00247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Belvoir, VA

Sources for this page

Verify at the official NPI Registry.