Individual provider Active NPI

William R Cooper, MD

  • Pulmonary Disease Physician
  • Virginia Beach, VA
National Provider Identifier
1124127147
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
0101019828 Issued in VA
Practice address
1008 First Colonial Rd
Suite 103
Virginia Beach, VA 23454-3071
Phone
(757) 481-2515
Fax
(757) 481-4064
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 0101019828 VA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101019828 VA

Addresses

Primary practice location

1008 First Colonial Rd
Suite 103
Virginia Beach, VA 23454-3071

Mailing address

PO Box 7068
Portsmouth, VA 23707-0068
Phone (757) 686-3508

Other identifiers 4

IdentifierTypeStateIssuer
V29930786OtherVACHAMPUS
5819202MedicaidVA
15609OtherVAOPTIMA
CIGNAOtherVA1470700004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090216000399 VA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 5890850424 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101019828VAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Jan 16, 2012 Accepting new patients
Bayview Physician Services, PC Critical Care Medicine CurrentSince Jan 16, 2012 Accepting new patients
Pulmonary Medicine of Virginia Beach, Inc. Pulmonary Disease Current Accepting new patients
Bayview Medical Center, Inc Past Accepting new patients
Bayview Physician Services, PC Past Accepting new patients

Locations

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

3241 Western Branch Blvd
Ste A
Chesapeake, VA 23321

1975 Glenn Mitchell Dr
Ste 302
Virginia Beach, VA 23456
Phone (757) 481-2515

1008 First Colonial Rd
Ste 103
Virginia Beach, VA 23454
Phone (757) 481-2515

1168 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 352-2020

Organizations & group practices 5

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1124127147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7068",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070068",
            "telephone_number": "757-686-3508",
            "fax_number": "757-686-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 FIRST COLONIAL RD",
            "address_2": "SUITE 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543071",
            "telephone_number": "757-481-2515",
            "fax_number": "757-481-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101019828",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101019828",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "V29930786",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5819202",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "15609",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1470700004",
            "identifier": "CIGNA",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.