Jerry Dewayne Cooper, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

013262 Issued in GA

Practice address

275 Collier Rd NW
Suite 290
Atlanta, GA 30309-1709

Phone

(404) 352-3300

Fax

(404) 352-9453

NPI assigned

Nov 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1396728598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 COLLIER RD NW",
            "address_2": "SUITE 290",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091709",
            "telephone_number": "404-352-3300",
            "fax_number": "404-352-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 COLLIER RD NW",
            "address_2": "SUITE 290",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091709",
            "telephone_number": "404-352-3300",
            "fax_number": "404-352-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JERRY",
        "middle_name": "DEWAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "013262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00134142G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darius Cooper, LCMHC, LPC, NCC, ACS
• Erica Cooper, BCBA
• Gary Cooper
• Jacinta Cooper, MD, PHD
• Jennifer Nicole Cooper, PMHNP-BC
• Jo Ann Washington Cooper
• Juliet Denise Cooper, RN
• Kamiesha Cooper
• Keevis Cooper
• Kieran Alexander Cooper, M.D..

• Nephrology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.