Individual provider Active NPI

Charles Cooper, DNP CRNA

  • Certified Registered Nurse Anesthetist
  • Valparaiso, IN
National Provider Identifier
1336505148
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28191129A Issued in IN
Practice address
85 E US Highway 6
Valparaiso, IN 46383-8947
Phone
(219) 263-4600
NPI assigned
Jan 8, 2016
Last updated
Jan 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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 28191129A IN Primary

Addresses

Primary practice location

85 E US Highway 6
Valparaiso, IN 46383-8947

Mailing address

85 E US Highway 6
Valparaiso, IN 46383-8947
Phone (219) 263-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160516001006 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709175755 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Rush Medical College of Rush University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Porte County Anesthesia Associates, LLCGroup PAC ID 4688633241, 26 clinicians

Practice addresses (Care Compare)

3500 Franciscan Way
Franciscian Health Michigan City
Michigan City, IN 46360-0021
Phone (219) 877-8511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
28191129AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Porter County Anesthesia Associates PC CurrentSince Apr 10, 2016 Accepting new patients
La Porte County Anesthesia Associates LLC CurrentSince Jul 1, 2019 Accepting new patients
Stat Anesthesia Specialists LTD Current Accepting new patients
Stat Anesthesia Specialists, LTD. CurrentSince Apr 1, 2019 Accepting new patients

Locations

18221 Torrence Ave
Ste 1B
Lansing, IL 60438
Phone (708) 474-7600

3111 Village Pt
Chesterton, IN 46304
Phone (219) 983-1401

900 I St
Ste 1
Laporte, IN 46350
Phone (219) 324-1670

301 W Homer St
Michigan City, IN 46360
Phone (219) 877-1033

301 W Homer St
#M
Michigan City, IN 46360
Phone (219) 877-1033

3500 Franciscan Way
Michigan City, IN 46360
Phone (219) 852-1524

8865 W 400 N
Ste 100
Michigan City, IN 46360
Phone (219) 877-2222

3630 Willowcreek Rd
Portage, IN 46368
Phone (219) 364-3000

10220 Wicker Ave
Ste 3
Saint John, IN 46373
Phone (219) 515-6943

1900 Roosevelt Rd
Valparaiso, IN 46383
Phone (219) 263-4900

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

Interoperability endpoints

  • Direct secure messaging: ccooper432576@direct.franciscanalliance.org

Organizations & group practices 4

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 2

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": "1452211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1336505148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 E US HIGHWAY 6",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463838947",
            "telephone_number": "219-263-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 E US HIGHWAY 6",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463838947",
            "telephone_number": "219-263-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DNP CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-08",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28191129A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; 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.