Malik Cooper, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA003468 Issued in GA

Practice address

3355 Cascade Rd SW Ste 102
Atlanta, GA 30311-3679

Phone

(404) 505-9030

Fax

(404) 505-0930

NPI assigned

Jul 8, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Genesis Sports Medicine and Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1861600520

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1164084471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 CASCADE RD SW STE 102",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303113679",
            "telephone_number": "404-505-9030",
            "fax_number": "404-505-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 CASCADE RD SW STE 102",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303113679",
            "telephone_number": "404-505-9030",
            "fax_number": "404-505-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MALIK",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA003468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kieran Alexander Cooper, M.D..
• Lacey Lee Cooper, RDH
• Lawrence Erwin Cooper, MD
• Lequiter Monet Cooper
• Lisa Cooper
• Mary Alice Cooper, PA
• Mychal Cooper
• Nakia Cooper
• Nasya Cooper
• Neil B Cooper, MD

• Physical Therapy Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.