Individual provider Active NPI

Earl R. Cooper, ATC

  • Athletic Trainer
  • Athens, GA
National Provider Identifier
1124688650
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
80 Issued in GA
Practice address
330 River Road 371 Ramsey Center 371 Ramsey Center
Athens, GA 30602-0001
Phone
(706) 542-6463
NPI assigned
Jun 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 80 GA Primary

Addresses

Primary practice location

330 River Road 371 Ramsey Center 371 Ramsey Center
Athens, GA 30602-0001

Mailing address

330 River Road 371 Ramsey Center 371 Ramsey Center
Athens, GA 30602-0001
Phone (706) 542-6463

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
80GAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1124688650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 RIVER ROAD 371 RAMSEY CENTER 371 RAMSEY CENTER",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306020001",
            "telephone_number": "706-542-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 RIVER ROAD 371 RAMSEY CENTER 371 RAMSEY CENTER",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306020001",
            "telephone_number": "706-542-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "EARL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "80",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

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