Kelli Anne Cooper, L.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA 60067981 Issued in WA

Practice address

6125 N Sunshine St Ste a
Coeur D Alene, ID 83815-8688

Phone

(208) 772-0802

NPI assigned

Nov 17, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1285901348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E WYOMING AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359618",
            "telephone_number": "208-640-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6125 N SUNSHINE ST STE A",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158688",
            "telephone_number": "208-772-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KELLI",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "L.M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60067981",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT109720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis B Cooke, MD
• Cooksey Counseling, PLLC
• Alison Cooksey, LCSW
• Austin J Cooper, LMSW
• Bryan Cooper
• Sean Cooper, PHARM D
• Coordinated Services of Idaho, LLC
• Brandon Cope
• Laurel Cope, PA-C
• Adele Copfer

• Massage Therapist in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.