NPIMap

Organization Active NPI

Cooper Clinic, PA

  • Clinic/Center
  • Fort Smith, AR
National Provider Identifier
1366464075
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MC-0254 Issued in AR
Legal business name
COOPER CLINIC, PA
Practice address
9616 Rogers Ave
Fort Smith, AR 72903-5769
Phone
(479) 274-2000
Fax
(479) 274-2194
NPI assigned
Jul 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Authorized official

Name
Curtis Ralston
Title
Ceo
Phone
(479) 274-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MC-0254 AR Primary

Addresses

Primary practice location

9616 Rogers Ave
Fort Smith, AR 72903-5769

Mailing address

PO Box 3528
Fort Smith, AR 72913-3528
Phone (479) 274-2000

National Provider Directory

National Provider Directory
Tax ID family
Cooper Clinic13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9616 Rogers Ave
Fort Smith, AR 72903
Phone (479) 242-8218

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445299200000",
    "number": "1366464075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3528",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729133528",
            "telephone_number": "479-274-2000",
            "fax_number": "479-274-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9616 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035769",
            "telephone_number": "479-274-2000",
            "fax_number": "479-274-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2015-10-20",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "479-274-2000"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AR",
            "license": "MC-0254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.