NPIMap

Individual provider Active NPI

Keith Cooper, MD

  • Family Medicine Physician
  • Conway, AR
National Provider Identifier
1295732816
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E0922 Issued in AR
Practice address
437 Denison St
Conway, AR 72034-6127
Phone
(501) 327-1325
Fax
(501) 327-1328
NPI assigned
Jun 29, 2005
Last updated
Oct 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E0922 AR Primary

Addresses

Primary practice location

437 Denison St
Conway, AR 72034-6127

Mailing address

PO Box 9662
Conway, AR 72033-9662
Phone (501) 852-1363

Other identifiers 4

IdentifierTypeStateIssuer
120531OtherARUNITED HEALTHCARE
5K846OtherARBLUE CROSS BLUE SHIELD
134689001MedicaidAR
17974000000OtherARQUALCHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818000119 AR Practitioner - Family Practice 1658405212 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Conway Regional Medical Center IncGroup PAC ID 3173428414, shared by 26 NPIs, 129 clinicians

Practice addresses (Care Compare)

437 Denison St
Conway, AR 72034-6127
Phone (501) 327-1325

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E0922ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dardanelle Regional, LLC CurrentSince Nov 1, 2025 Accepting new patients
Conway Regional Medical Center Inc Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Dardanelle Regional, LLC CurrentSince Nov 1, 2025 Accepting new patients
Dardanelle Regional, LLC CurrentSince Nov 1, 2025 Accepting new patients
Conway Regional Medical Center, Inc Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Conway Regional Medical Center, Inc Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
Dardanelle Regional, LLC Family Medicine CurrentSince May 1, 2023 Accepting new patients
Conway Regional Medical Center Inc Family Medicine Current Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients

Locations

2526 Highway 65 S
Ste 201
Clinton, AR 72031
Phone (501) 745-3388

1 Medical Ln
Conway, AR 72034
Phone (501) 329-2948

1700 Altus St
Ste 110
Conway, AR 72032
Phone (501) 852-1366

437 Denison St
Conway, AR 72034
Phone (501) 327-1325

437 Denison St
Ste 2
Conway, AR 72034
Phone (501) 504-2330

200 N 3rd St
Dardanelle, AR 72834
Phone (479) 229-2827

200 N 3rd St
Ste 1
Dardanelle, AR 72834
Phone (479) 229-6191

110 N Broadview St
Greenbrier, AR 72058
Phone (501) 679-3551

606 Highway 365
Mayflower, AR 72106
Phone (501) 358-6905

108 Skyline Dr
Russellville, AR 72801
Phone (479) 968-7170

1159 Main St
Vilonia, AR 72173
Phone (501) 796-2791

Organizations & group practices 9

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1295732816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9662",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720339662",
            "telephone_number": "501-852-1363",
            "fax_number": "501-852-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 DENISON ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346127",
            "telephone_number": "501-327-1325",
            "fax_number": "501-327-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-29",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E0922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "120531",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5K846",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134689001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "17974000000",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.