Bradley Alan Cooper, OT
Individual provider Active NPI Ergonomics Occupational Therapist · Shaw, MS
NPI 1174744932 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1174744932
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ergonomics Occupational Therapist 225XE1200X
- License
- OT0258 (MS)
- Practice address
- 12 Carmelita CV
Shaw, MS 38773-9619 - Phone
- (662) 846-7228
- Fax
- (662) 843-5434
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT0258 | MS | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT0258 | MS | |
| Ergonomics Occupational Therapist | 225XE1200X | OT0258 | MS | Yes |
Addresses
Primary practice location
12 Carmelita CV
Shaw, MS 38773-9619
Mailing address
12 Carmelita CV
Shaw, MS 38773-9619
Phone (662) 846-7228
Other providers in Shaw, MS
- Boa Vida Hospital of Aberdeen, Ms LLC
- Willie Mary Bolden
- Shekendra Patty Bryant
- Victoria Curry
- Kim Davis
- Naala Latrice Davis
- Delta Drugs Inc
- Kimberly Drake
All providers in Shaw, MS · Ergonomics Occupational Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.