Individual provider Active NPI

Kristin Nicole Cowperthwaite, M.D.

  • Emergency Medicine Physician
  • Camden, NJ
National Provider Identifier
1174840912
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD446033 Issued in PA
Practice address
1 Cooper PLZ
Department of Emergency Medicine
Camden, NJ 08103-1461
Phone
(410) 245-8050
NPI assigned
May 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD446033 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1 Cooper PLZ
Department of Emergency Medicine
Camden, NJ 08103-1461

Mailing address

100 E Lehigh Ave
Department of Emergency Medicine
Philadelphia, PA 19125-1012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150918001821 MD Practitioner - Emergency Medicine 2860658689 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WHC Physician Group LLC CurrentSince Aug 1, 2015 Accepting new patients
WHC Emerg Phys CurrentSince Aug 1, 2015 Accepting new patients

Locations

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

11355 Pembrooke Sq
Ste 108
Waldorf, MD 20603
Phone (202) 877-6733

Organizations & group practices 2

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": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1174840912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LEHIGH AVE",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191251012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "410-245-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWPERTHWAITE",
        "first_name": "KRISTIN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-03",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD446033",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.