NPIMap

Organization Active NPI

Ivan N Cooper, DPM, PC

  • Podiatrist
  • Knoxville, TN
National Provider Identifier
1255413316
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
IVAN N COOPER, DPM, PC
Practice address
1932 Alcoa Hwy
Suite C-480
Knoxville, TN 37920-1527
Phone
(865) 632-5700
Fax
(865) 632-5778
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Authorized official

Name
Dr. Ivan N Cooper, DPMNPI 1952491748
Title
President
Phone
(865) 632-5700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

1932 Alcoa Hwy
Suite C-480
Knoxville, TN 37920-1527

Mailing address

1932 Alcoa Hwy
Suite C-480
Knoxville, TN 37920-1527
Phone (865) 632-5700

Other names 1

  • Knoxville Footcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930077932 TN DME Supplier - Physician - Podiatry 8426177627 Practice locations: Knoxville, TN
O20130829000373 TN Part B Supplier - Clinic/Group Practice 8426177627 Receives reassigned benefits from 6 practitioners
Practice locations: Knoxville, TN; Lenoir City, TN

National Provider Directory

National Provider Directory

Locations

101 E Blount Ave
Ste 600
Knoxville, TN 37920
Phone (865) 523-5655

1932 Alcoa Hwy
Ste C480
Knoxville, TN 37920
Phone (865) 632-5700

1932 Alcoa Hwy
Ste 480
Knoxville, TN 37920
Phone (865) 632-5700

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375920000000",
    "number": "1255413316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1932 ALCOA HWY",
            "address_2": "SUITE C-480",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201527",
            "telephone_number": "865-632-5700",
            "fax_number": "865-632-5778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 ALCOA HWY",
            "address_2": "SUITE C-480",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201527",
            "telephone_number": "865-632-5700",
            "fax_number": "865-632-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVAN N COOPER, DPM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2013-08-08",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-632-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knoxville Footcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.