Kent J Cooper, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15873 Issued in KS

Practice address

2401 S Tucker Ave
Ste. 2
Pittsburg, KS 66762-6609

Phone

(620) 231-6280

Fax

(620) 231-6342

NPI assigned

Oct 2, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Baxter Springs, KS
  • NPI 1487351086
  NPD (past)
• Pittsburg Family Medicine LLC

  • Family Medicine Physician
  • Pittsburgh, KS
  • NPI 1740398924
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215020763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S TUCKER AVE",
            "address_2": "STE. 2",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667626609",
            "telephone_number": "620-231-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S TUCKER AVE",
            "address_2": "STE. 2",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667626609",
            "telephone_number": "620-231-6280",
            "fax_number": "620-231-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KENT",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "15873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100086050A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Mental Health Center of Crawford County
• Complete Hearing Care (Lowry Hearing Aid Center)
• Comprehensive Hearing Solutions LLC
• Patricia Ann Cook, LMSW
• Dustin Cooney
• Kathryn Goodwin Cornelius, MD
• Brent Leroy Cosens, D.O.
• Julie Costello, LCMFT
• Michelle L Coulter Morrell, LSCSW
• Coummunity Mental Health Center of Crawford County

• Family Medicine Physician in Pittsburg, KS
• Providers in Pittsburg, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.