Individual provider Active NPI

Douglas Thurman Cooper, M.D.

  • Psychiatry Physician
  • Brunswick, GA
National Provider Identifier
1255495131
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
37180 Issued in GA
Practice address
107 Drew Cir
Brunswick, GA 31525-1049
Phone
(917) 705-1222
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 37180 GA Primary

Addresses

Primary practice location

107 Drew Cir
Brunswick, GA 31525-1049

Mailing address

107 Drew Cir
Brunswick, GA 31525-1049
Phone (917) 705-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20110509000721 GA Practitioner - Psychiatry 2062303498 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Michigan Medical School, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindset Healthcare PCGroup PAC ID 0547514606, 2 clinicians
Mindbodysoul Mental Health and Family Practice LLCGroup PAC ID 8729432489, 3 clinicians

Practice addresses (Care Compare)

135 Bradford SQ
Suite B
Fayetteville, GA 30215-1902
Phone (470) 646-3738

1766 Lawrenceville Hwy
Decatur, GA 30033-5641
Phone (470) 746-3142

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mindset Healthcare, PC CurrentSince Nov 1, 2019 Accepting new patients
Mindbodysoul Mental Health & Family Practice LLC Psychiatry CurrentSince Dec 1, 2024 Accepting new patients
HHC St. Simons Inc CurrentSince Apr 9, 2011 Accepting new patients
Atlanta Psychotherapy, LLC CurrentSince Dec 23, 2015 Accepting new patients
Bronx Addiction Services Integrated Concepts System Inc PastSince Jan 20, 2009 Accepting new patients

Locations

1766 Lawrenceville Hwy
Decatur, GA 30033
Phone (470) 746-3142

135 Bradford Sq
Ste B
Fayetteville, GA 30215
Phone (470) 646-3738

2927 Demere Rd
St Simons Island, GA 31522
Phone (912) 638-1999

831 Fairways Ct
Ste A
Stockbridge, GA 30281
Phone (770) 389-1925

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1255495131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 DREW CIR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315251049",
            "telephone_number": "917-705-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 DREW CIR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315251049",
            "telephone_number": "917-705-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "DOUGLAS",
        "middle_name": "THURMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2022-04-12",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "37180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.