NPIMap

Individual provider Active NPI

Mark C Cooper, M.D.

  • Family Medicine Physician
  • Scottsboro, AL
National Provider Identifier
1225080849
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22070 Issued in AL
Practice address
505 Burlington St
Scottsboro, AL 35768-4216
Phone
(256) 259-4100
Fax
(256) 259-4104
NPI assigned
May 16, 2006
Last updated
Jul 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22070 AL Primary

Addresses

Primary practice location

505 Burlington St
Scottsboro, AL 35768-4216

Mailing address

505 Burlington St
Scottsboro, AL 35768-4216
Phone (256) 259-4100

Other identifiers 1

IdentifierTypeStateIssuer
051529856MedicaidAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.cooper@fmfyf.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050926000220 AL Practitioner - Family Practice 1052345360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medicine for Your Family, PCGroup PAC ID 6507891637, 2 clinicians

Practice addresses (Care Compare)

505 Burlington St
Scottsboro, AL 35768-4216
Phone (256) 259-4100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy22
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions28
Removal or shaving of skin growth1-10
Skin biopsy17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22070ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine for Your Family PC Family Medicine CurrentSince Sep 3, 2005 Accepting new patients
The Valley Foundation Current Accepting new patients

Locations

301 Governors Dr SW
Huntsville, AL 35801
Phone (256) 536-5511

505 Burlington St
Scottsboro, AL 35768
Phone (256) 259-4100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACBBAA/Endpoint/ACBBAA

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1225080849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 BURLINGTON ST",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684216",
            "telephone_number": "256-259-4100",
            "fax_number": "256-259-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 BURLINGTON ST",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684216",
            "telephone_number": "256-259-4100",
            "fax_number": "256-259-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MARK",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "22070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051529856",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.cooper@fmfyf.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "505 Burlington St",
            "city": "Scottsboro",
            "state": "AL",
            "country_code": "US",
            "postal_code": "357684216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsboro, AL

Sources for this page

Verify at the official NPI Registry.