Individual provider Active NPI

Raymond Lebron Cooper, M.D.

  • Anesthesiology Physician
  • Memphis, TN
National Provider Identifier
1376502120
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
49287 Issued in TN
Practice address
877 Jefferson Ave
Memphis, TN 38103-2807
Phone
(901) 448-5893
Fax
(901) 448-5540
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME70972 FL
Anesthesiology Physician 207L00000X MD.09211R LA
Anesthesiology Physician 207L00000X 49287 TN Primary

Addresses

Primary practice location

877 Jefferson Ave
Memphis, TN 38103-2807

Mailing address

877 Jefferson Ave
Attn: Provider Enrollment
Memphis, TN 38103-2807
Phone (901) 545-7302

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RCOOPER12@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180808000088 IN Practitioner - Anesthesiology 5991721318 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.09211RLAMDAnesthesiology Physician
49287TNMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC Current Accepting new patients
Arnett Clinic, LLC CurrentSince Sep 1, 2018 Accepting new patients
Arnett Clinic, LLC Anesthesiology CurrentSince Sep 1, 2018 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients
Ochsner Clinic LLC Past Accepting new patients
American Anesthesiology of Florida, Inc Anesthesiology Past Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

2600 Greenbush St
Lafayette, IN 47904

5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448

Interoperability endpoints

  • Direct secure messaging: rcooper12@direct.iuhealth.org

Organizations & group practices 6

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1376502120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-545-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-448-5893",
            "fax_number": "901-448-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "RAYMOND",
        "middle_name": "LEBRON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME70972",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "MD.09211R",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "49287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RCOOPER12@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "5165 McCarty Ln",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479058764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.