NPIMap

Individual provider Active NPI

Timothy Lee Cooper, PA-C

  • Physician Assistant
  • Conrad, IA
National Provider Identifier
1366427767
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001336 Issued in IA
Practice address
105 Church
Box 40
Conrad, IA 50621-0040
Phone
(641) 366-2123
Fax
(641) 366-2143
NPI assigned
Dec 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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 001336 IA Primary

Addresses

Primary practice location

105 Church
Box 40
Conrad, IA 50621-0040

Mailing address

105 Church Street
Box 40
Conrad, IA 50621
Phone (641) 366-2123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20090122000471 IA Practitioner - Physician Assistant 6901960707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unitypoint Health - Marshalltown 24 clinicians

Practice addresses (Care Compare)

51 Unitypoint Way
Suite 100
Marshalltown, IA 50158-4750
Phone (641) 844-6259

55 Unitypoint Way
Marshalltown, IA 50158-4749
Phone (641) 754-5145

Hospital & facility affiliations

  • Unitypoint at Home Home health agency, Waterloo, IA, CCN 167147
  • Unitypoint Health - Marshalltown Hospital, Marshalltown, IA, CCN 160001
  • Grundy County Memorial Hospital Hospital, Grundy Center, IA, CCN 161303

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Physician Assistant CurrentSince Jun 7, 2022 Accepting new patients
Salahuddin Syed MD PC Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Jun 7, 2022 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Unitypoint Health - Marshalltown CurrentSince May 1, 2017 Accepting new patients
Allen Memorial Hospital Corporation Past Accepting new patients
Central Iowa Healthcare Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

205 N Hartwig St
Conrad, IA 50621
Phone (614) 366-2123

55 Unitypoint Way
Marshalltown, IA 50158
Phone (641) 754-5145

3 S 4th Ave
Marshalltown, IA 50158
Phone (641) 754-5145

405 E Main St
Marshalltown, IA 50158
Phone (641) 753-2752

Interoperability endpoints

  • Direct secure messaging: tcooper84448@uihcdirect.org
  • Direct secure messaging: tcooper639201@direct.unitypoint.org

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 3

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": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1366427767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CHURCH STREET",
            "address_2": "BOX 40",
            "city": "CONRAD",
            "state": "IA",
            "postal_code": "50621",
            "telephone_number": "641-366-2123",
            "fax_number": "641-366-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CHURCH",
            "address_2": "BOX 40",
            "city": "CONRAD",
            "state": "IA",
            "postal_code": "506210040",
            "telephone_number": "641-366-2123",
            "fax_number": "641-366-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "TIMOTHY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conrad, IA

Sources for this page

Verify at the official NPI Registry.