Individual provider Active NPI

Cynthia S Cooper, MD

  • Gynecology Physician
  • Dover, NH
National Provider Identifier
1336139294
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
6941 Issued in NH
Practice address
15 Old Rollinsford Rd
Suite 102
Dover, NH 03820-2868
Phone
(603) 749-4963
Fax
(603) 742-7094
NPI assigned
Oct 24, 2005
Last updated
Dec 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 6941 NH Primary

Addresses

Primary practice location

15 Old Rollinsford Rd
Suite 102
Dover, NH 03820-2868

Mailing address

15 Old Rollinsford Rd
Suite 102
Dover, NH 03820-2868
Phone (603) 749-4963

Other identifiers 2

IdentifierTypeStateIssuer
3078791MedicaidNH
1336139294MedicaidME

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gynecology and Infertility Associates, PA Gynecology PastSince Sep 3, 2008 Accepting new patients

Organizations & group practices 1

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1336139294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 OLD ROLLINSFORD RD",
            "address_2": "SUITE 102",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202868",
            "telephone_number": "603-749-4963",
            "fax_number": "603-742-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OLD ROLLINSFORD RD",
            "address_2": "SUITE 102",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202868",
            "telephone_number": "603-749-4963",
            "fax_number": "603-742-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CYNTHIA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NH",
            "license": "6941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078791",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336139294",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.