Individual provider Active NPI

Elisabeth Brenda Cooper

  • Physician Assistant
  • Owings Mills, MD
National Provider Identifier
1356947063
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9199 Reisterstown Rd Ste 101B
Owings Mills, MD 21117-4513
Phone
(443) 898-8160
Fax
(443) 898-8916
NPI assigned
Dec 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

9199 Reisterstown Rd Ste 101B
Owings Mills, MD 21117-4513

Mailing address

9199 Reisterstown Rd Ste 101B
Owings Mills, MD 21117-4513
Phone (443) 898-8160

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL lcooper@steadystridesmd.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210112002901 MD Practitioner - Physician Assistant 3971916966 Reassigns benefits to 1 organization
I20210112002950 DC Practitioner - Physician Assistant 5698188688 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fall Prevention and Stroke Rehab Physician, LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

9001 Cherry Ln
Laurel, MD 20708
Phone (301) 498-8558

9199 Reisterstown Rd
Ste 101B
Owings Mills, MD 21117
Phone (443) 543-6773

Interoperability endpoints

  • Direct secure messaging: elisabeth.cooper.1@24618.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/24618/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1356947063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9199 REISTERSTOWN RD STE 101B",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174513",
            "telephone_number": "443-898-8160",
            "fax_number": "443-898-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9199 REISTERSTOWN RD STE 101B",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174513",
            "telephone_number": "443-898-8160",
            "fax_number": "443-898-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ELISABETH",
        "middle_name": "BRENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "lcooper@steadystridesmd.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "9199 Reisterstown Rd Ste 101B",
            "city": "Owings Mills",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211174513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.