Active NPI
Douglas M Cooper, MD
- Psychiatry Physician
- Wailuku, HI
National Provider Identifier
1215085576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD-2108
- Practice address
- 121 Mahalani St.
Wailuku, HI 96793 - Phone
- (808) 984-2150
- Fax
- (808) 984-2155
- NPI assigned
- Jan 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD-2108 | HI | Primary |
Addresses
Primary practice location
121 Mahalani St.
Wailuku, HI 96793
Mailing address
275 Ulumalu Rd.
Haiku, HI 96708
Phone (808) 258-1965
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00000123 | Other | HI | ALOHA CARE PROVIDER# |
| 035529 | Medicaid | HI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-2108 | HI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1215085576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 ULUMALU RD.",
"city": "HAIKU",
"state": "HI",
"postal_code": "96708",
"telephone_number": "808-258-1965",
"fax_number": "808-984-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 MAHALANI ST.",
"city": "WAILUKU",
"state": "HI",
"postal_code": "96793",
"telephone_number": "808-984-2150",
"fax_number": "808-984-2155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "DOUGLAS",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "HI",
"license": "MD-2108",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALOHA CARE PROVIDER#",
"identifier": "00000123",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "035529",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wailuku, HI
- Community Clinic of Maui, Inc.
- Community Mental Health Center Clubhouse- Hale O Lanakila
- Comprehensive Health and Attitude Management Programs Inc
- Diane Conklin, APRN
- Douglas Wesley Cook, M.D.
- Cora S Tasaki MD Inc
- Alyssa Corcoran
- Core Physical Therapy of Maui
- Ramona Keiko Lee Corson, R.PH, PHARM.D.,
- Robert Scott Corson, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.