Individual provider Active NPI

Alexander Raphael Cooker, D.C.

  • Chiropractor
  • Charleston, SC
National Provider Identifier
1386603454
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
SC2639 Issued in SC
Practice address
912 Savannah Hwy
Charleston, SC 29407-7802
Phone
(843) 225-4080
Fax
(843) 225-5210
NPI assigned
Mar 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X SC2639 SC Primary

Addresses

Primary practice location

912 Savannah Hwy
Charleston, SC 29407-7802

Mailing address

912 Savannah Hwy
Charleston, SC 29407-7802
Phone (843) 225-4080

Other identifiers 1

IdentifierTypeStateIssuer
CH2639MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000004 SC Practitioner - Chiropractic 6204805245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

912 Savannah Hwy
Charleston, SC 29407-7802
Phone (843) 225-4080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC2639SCMDChiropractor
2639SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Chiropractic Chiropractor CurrentSince Feb 1, 2002 Accepting new patients

Locations

912 Savannah Hwy
Charleston, SC 29407
Phone (843) 225-4080

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386603454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 SAVANNAH HWY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077802",
            "telephone_number": "843-225-4080",
            "fax_number": "843-225-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 SAVANNAH HWY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077802",
            "telephone_number": "843-225-4080",
            "fax_number": "843-225-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKER",
        "first_name": "ALEXANDER",
        "middle_name": "RAPHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "SC2639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2639",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.