Active NPI
John K Cooper, LICENSEDPSYCHOLOGIST
- Psychologist
- Maumee, OH
National Provider Identifier
1255347407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2223
- Practice address
- 3600 Briarfield Blvd
Ste. 3
Maumee, OH 43537-8919 - Phone
- (419) 866-2830
- Fax
- (419) 866-2831
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2223 | OH | Primary |
Addresses
Primary practice location
3600 Briarfield Blvd
Ste. 3
Maumee, OH 43537-8919
Mailing address
3600 Briarfield Blvd
Ste. 3
Maumee, OH 43537-8919
Phone (419) 866-2830
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 271336 | Other | OH | VALUE OPTIONS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2223 | OH | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255347407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 BRIARFIELD BLVD",
"address_2": "STE. 3",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435378919",
"telephone_number": "419-866-2830",
"fax_number": "419-866-2831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 BRIARFIELD BLVD",
"address_2": "STE. 3",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435378919",
"telephone_number": "419-866-2830",
"fax_number": "419-866-2831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "JOHN",
"middle_name": "K",
"credential": "LICENSEDPSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "2223",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "271336",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maumee, OH
Sources for this page
- 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.