Individual provider Active NPI

Laura Kelly Cooper, D.C.

  • Chiropractor
  • Richmond, IN
National Provider Identifier
1174660237
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002028A Issued in IN
Practice address
4201 S a St
Richmond, IN 47374-6049
Phone
(765) 965-9500
Fax
(765) 965-0432
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002028A IN Primary

Addresses

Primary practice location

4201 S a St
Richmond, IN 47374-6049

Mailing address

4201 S a St
Richmond, IN 47374-6049
Phone (765) 965-9500

Other practice location 1

4201 s a st
Richmond, IN 47374-6049
Phone (765) 965-9500

Other identifiers 2

IdentifierTypeStateIssuer
300070238MedicaidIN
200468130AMedicaidIN

Other names 1

  • Laura Kelly McMahon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050120000212 IN Practitioner - Chiropractic 5890751234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4201 S a St
Richmond, IN 47374-6049
Phone (765) 965-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MHBN Inc. Chiropractor CurrentSince Aug 7, 2002 Accepting new patients

Locations

3577 E Main St
Richmond, IN 47374
Phone (765) 965-9500

4201 S A St
Richmond, IN 47374
Phone (765) 965-9500

Organizations & group practices 1

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1174660237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 S A ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473746049",
            "telephone_number": "765-965-9500",
            "fax_number": "765-965-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 S A ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473746049",
            "telephone_number": "765-965-9500",
            "fax_number": "765-965-0432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 s a st",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "IN",
            "postal_code": "473746049",
            "country_code": "US",
            "telephone_number": "765-965-9500",
            "fax_number": "765-965-0432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "LAURA",
        "middle_name": "KELLY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002028A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300070238",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200468130A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "MCMAHON",
            "middle_name": "KELLY",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richmond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.