Individual provider Active NPI

Diana Susan Cooper, PHARMD

  • Pharmacist
  • Howell, MI
National Provider Identifier
1316584089
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302033516 Issued in MI
Practice address
108 W Highland Rd
Howell, MI 48843-1159
Phone
(517) 552-0205
NPI assigned
Dec 2, 2019
Last updated
Dec 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302033516 MI Primary

Addresses

Primary practice location

108 W Highland Rd
Howell, MI 48843-1159

Mailing address

1225 Lobelia LN
Dewitt, MI 48820-7409
Phone (517) 290-7302

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302033516MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Co of Michigan PastSince Dec 9, 2019 Accepting new patients
Kroger Co of Michigan PastSince Dec 9, 2019 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": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1316584089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 LOBELIA LN",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488207409",
            "telephone_number": "517-290-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W HIGHLAND RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488431159",
            "telephone_number": "517-552-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "DIANA",
        "middle_name": "SUSAN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302033516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.