Elisabeth Cooper, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA22308 Issued in CA

Practice address

1035 Placer St
Redding, CA 96001-1125

Phone

(530) 246-5710

Fax

(530) 229-1206

NPI assigned

Jun 12, 2006

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 identifiers 1

Other names 1

• Miss Elisabeth Vanwyke Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: elisabeth.cooperpac.p1@direct.schc.nextgenshare.com

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.

• Redding Rancheria

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1104859354
  Medicare reassignment NPD
• Shasta Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1114533171
  Medicare reassignment
• Redding Rancheria

  • Federally Qualified Health Center (FQHC)
  • Weaverville, CA
  • NPI 1386164580
  NPD
• Redding Rancheria

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1780423244
  NPD
• Shasta Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1356815542
  NPD

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1114969003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 992790",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960992790",
            "telephone_number": "530-246-5710",
            "fax_number": "530-229-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PLACER ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011125",
            "telephone_number": "530-246-5710",
            "fax_number": "530-229-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ELISABETH",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-002670",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085-002670",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISABETH",
            "last_name": "VANWYKE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lidia Contrereas, CASE MANAGER
• Brian Karl Cook
• Helene Cook
• Tina Cook
• Charles H Cooley, DDS MS
• Jeffrey Brian Cooper, OD
• Haylee Coopman
• John Andrew Copeland, MD
• Sidney Rapier Cormier Jr., PH.D.
• Cornerstone Health & Wellness Group, Inc

• Physician Assistant in Redding, CA
• Providers in Redding, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.