Individual provider Active NPI

Marshall Cooperson, DO

  • Internal Medicine Physician
  • Napa, CA
National Provider Identifier
1194743195
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A5492 Issued in CA
Practice address
3010 Beard Rd
Napa, CA 94558-3442
Phone
(707) 257-1550
Fax
(707) 257-8219
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A5492 CA Primary

Addresses

Primary practice location

3010 Beard Rd
Napa, CA 94558-3442

Mailing address

3212 Jefferson St # 196
Napa, CA 94558-3436
Phone (707) 257-1550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20060317000538 CA Practitioner - Internal Medicine 9032126941 Reassigns benefits to 1 organization
Practice locations: Napa, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A5492CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Health Northern California, LLC CurrentSince May 1, 2020 Accepting new patients
St. Joseph Health Northern California, LLC CurrentSince May 1, 2020 Accepting new patients
St. Joseph Health Northern California, LLC Current Accepting new patients
Gunnell, M.D., Inc Past Accepting new patients

Locations

3300 Renner Dr
Fortuna, CA 95540
Phone (707) 725-3361

1000 Trancas St
Napa, CA 94558
Phone (707) 226-2901

Organizations & group practices 4

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1194743195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 JEFFERSON ST # 196",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583436",
            "telephone_number": "707-257-1550",
            "fax_number": "707-257-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 BEARD RD",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583442",
            "telephone_number": "707-257-1550",
            "fax_number": "707-257-8219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPERSON",
        "first_name": "MARSHALL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A5492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.