Individual provider Active NPI

William T Cooper, CRNA

  • Certified Registered Nurse Anesthetist
  • Independence, MO
National Provider Identifier
1093786451
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1318997 Issued in MO
Practice address
1515 W Truman Rd
Suite 108
Independence, MO 64050-3436
Phone
(816) 461-3131
Fax
(816) 461-1662
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1318997 MO Primary

Addresses

Primary practice location

1515 W Truman Rd
Suite 108
Independence, MO 64050-3436

Mailing address

1515 W Truman Rd
Suite 108
Independence, MO 64050-3436
Phone (816) 461-3131

Other practice location 1

2700 Clay Edwards Dr Ste 240
North Kansas City, MO 64116-3254
Phone (816) 691-2021

Other identifiers 1

IdentifierTypeStateIssuer
913553202MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1318997MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Meritas Health Corporation Past Accepting new patients
Independence Anesthesia Inc Past Accepting new patients

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1093786451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W TRUMAN RD",
            "address_2": "SUITE 108",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640503436",
            "telephone_number": "816-461-3131",
            "fax_number": "816-461-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W TRUMAN RD",
            "address_2": "SUITE 108",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640503436",
            "telephone_number": "816-461-3131",
            "fax_number": "816-461-1662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Clay Edwards Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163254",
            "country_code": "US",
            "telephone_number": "816-691-2021",
            "fax_number": "816-346-7690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "WILLIAM",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "1318997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "913553202",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.