Candace Sue Cooley, M D

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME77965 Issued in FL

Practice address

11 Racetrack Rd NE
Suite D-2
Fort Walton Beach, FL 32547-1882

Phone

(850) 586-7661

Fax

(850) 586-7679

NPI assigned

Jun 15, 2006

Last updated

Jun 26, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Radiance of the Emerald Coast

  • Specialist
  • Fort Walton Beach, FL
  • NPI 1962803759
  Authorized official Same address or phone

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1104860089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 RACETRACK RD NE",
            "address_2": "SUITE D-2",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471882",
            "telephone_number": "850-586-7661",
            "fax_number": "850-586-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RACETRACK RD NE",
            "address_2": "SUITE D-2",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471882",
            "telephone_number": "850-586-7661",
            "fax_number": "850-586-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "CANDACE",
        "middle_name": "SUE",
        "credential": "M D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME77965",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "47511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Comprehensive Pain Medicine Inc
• Melodie Lynn Conti, RBT
• Brandon Wade Cook, MD
• Darren L. Cook, DO
• Michayla Cook, LMHC
• Sally A. Cooper, D.O.
• Yvonne Cooper
• Sydney Ilana Cope
• Crystal Gillette Copeland
• David I Copeland, MA

• Obstetrics & Gynecology Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.