Individual provider Active NPI

Paul David Cooper Jr., C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Camp Lejeune, NC
National Provider Identifier
1265702187
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
82576 Issued in CA
Practice address
100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538
Phone
(910) 450-4159
Fax
(910) 450-4194
NPI assigned
Jan 10, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 82576 CA Primary

Addresses

Primary practice location

100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538

Mailing address

100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TN, TX, OR4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20231205003853 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547405425 Reassigns benefits to 2 organizations
I20250423001974 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547405425 Reassigns benefits to 1 organization
I20250801001939 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547405425 Reassigns benefits to 1 organization
I20251111001943 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547405425 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

940 E 5TH St
Coquille, OR 97423-1666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
82576CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Coquille Valley Hospital District CurrentSince Dec 15, 2025 Accepting new patients
Coquille Valley Hospital District CurrentSince Dec 15, 2025 Accepting new patients
Northeastern Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 13, 2025 Accepting new patients
Texas Ams PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 18, 2025 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Mar 7, 2025 Accepting new patients
Valley Regional Anesthesia Associates Inc CurrentSince Dec 30, 2024 Accepting new patients
MD Cyrus Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

5330 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-2273

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

940 E 5th St
Coquille, OR 97423
Phone (541) 396-3101

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

941 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 855-3255

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

1815 N Stanton St
El Paso, TX 79902
Phone (915) 533-8412

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5c5c3b5c-6128-40bc-b71b-102ccb82d7e7/

Organizations & group practices 7

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": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1265702187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-4159",
            "fax_number": "910-450-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-10",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "82576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Lejeune, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.