Dr. Michelle M. Cooper, PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

1038 Issued in SC

Legal business name

DR. MICHELLE M. COOPER, PA

Practice address

24 Potomac Ave
Greenville, SC 29605-2118

Phone

(864) 277-4420

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Michelle Cooper, O.D.NPI 1265491260

Title

President

Phone

(864) 901-5751

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

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

• Michelle M Cooper, O.D.

  • Optometrist
  • Greenville, SC
  • NPI 1265491260
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1386015030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 POTOMAC AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296052118",
            "telephone_number": "864-277-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 POTOMAC AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296052118",
            "telephone_number": "864-277-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MICHELLE M. COOPER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-901-5751",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D10389",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Greenville, SC
• Providers in Greenville, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.