Individual provider Active NPI

Peter Armitage Coopperrider, MD

  • Specialist
  • Kirkland, WA
National Provider Identifier
1265506042
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD00015596 Issued in WA
Practice address
12911 120TH Ave NE Ste G100
Kirkland, WA 98034-3027
Phone
(425) 899-4144
Fax
(425) 899-4148
NPI assigned
Nov 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD00015596 WA Primary

Addresses

Primary practice location

12911 120TH Ave NE Ste G100
Kirkland, WA 98034-3027

Mailing address

12911 120TH Ave NE Ste G100
Kirkland, WA 98034-3027
Phone (425) 899-4144

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00015596WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Strother Dermatology and Laser Treatment Center PLLC PastSince Oct 10, 2018 Accepting new patients
Sam Naficy, MD, PS, Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265506042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE STE G100",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343027",
            "telephone_number": "425-899-4144",
            "fax_number": "425-899-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE STE G100",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343027",
            "telephone_number": "425-899-4144",
            "fax_number": "425-899-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPPERRIDER",
        "first_name": "PETER",
        "middle_name": "ARMITAGE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00015596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

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.

Verify at the official NPI Registry.