Gregory J Cooper

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD61883 Issued in TN

Practice address

102 E Ravine Rd
Kingsport, TN 37660-3814

Phone

(423) 245-9600

NPI assigned

Apr 27, 2017

Sex

Male

Sole proprietor

No

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.

• Medical Education Assistance Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480

  Family Medicine, TN

  Medicare reassignment Care Compare group NPD
• Medical Education Assistance Corporation

  • Clinical Medical Laboratory
  • Mountain Home, TN
  • NPI 1235236613
  Care Compare group
• Medical Education Assistance Corporation

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1588786768

  Family Medicine

  NPD (past)

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

• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400

  Hospital

  Care Compare affiliation

Specialty

Family Practice

Education

East Tennessee State University Quillen College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Education Assistance Corporation 168 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 1, 2024.

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1245765239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-245-9600",
            "fax_number": "423-224-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603814",
            "telephone_number": "423-245-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "GREGORY",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-27",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD61883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q042523",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristi Cook, FNP
• Lisa Renee Cook, FNP
• Nancy Maria Kanarski Cook, PA
• Bryan Cooke, MSN, APRN, PMHNP-BC
• Carli J Cooper, D.O.
• Virginia Diane Copas, RN.C.
• Cara Copeland
• Jack Corbett
• Jared Cordon, MD
• Kevin Scott Cornwell, MD

• All providers in Kingsport, TN
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.