NPIMap

Individual provider Active NPI

Warren Todd Cooper, MD

  • Family Medicine Physician
  • Columbia, MO
National Provider Identifier
1396837217
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T2006017755 Issued in MO
Practice address
303 N Keene St
Suite 301
Columbia, MO 65201-7193
Phone
(573) 449-0808
Fax
(573) 442-1331
NPI assigned
Sep 28, 2006
Last updated
Feb 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T2006017755 MO Primary

Addresses

Primary practice location

303 N Keene St
Suite 301
Columbia, MO 65201-7193

Mailing address

303 N Keene St
Suite 301
Columbia, MO 65201-7193
Phone (573) 449-0808

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081208000164 MO Practitioner - Family PracticePractitioner - Emergency Medicine 4789745837 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.77 of 100Reported as individual
Quality
100
Improvement activities
0
Cost
84.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T2006017755MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Camden Emergency Group LLC CurrentSince May 1, 2012 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC CurrentSince Nov 1, 2014 Accepting new patients
Capital Emergency Physicians, PC CurrentSince Jan 1, 2016 Accepting new patients
Moberly HBP Medical Group LLC Past Accepting new patients
Lake Regional Health System PastSince Jun 6, 2024 Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

Ownership & related parties

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lake Regional Health SystemOsage Beach, MO, CCN 260186 Hospital Corporate Director Jun 6, 2024
Lake Regional Health SystemOsage Beach, MO, CCN 265429 Skilled nursing facility Managing Control - Governing Body Jun 6, 2024
Lake Regional HospiceOsage Beach, MO, CCN 261672 Hospice Corporate Director Jun 6, 2024
Lake Regional Clinic-Osage BeachOsage Beach, MO, CCN 268709 Rural health clinic Corporate Director Jun 6, 2024
Lake Regional Clinic-IberiaIberia, MO, CCN 268710 Rural health clinic Corporate Director Jun 6, 2024
Lake Regional Clinic CamdentonCamdenton, MO, CCN 268707 Rural health clinic Corporate Director Jun 6, 2024
Lake Regional Clinic-Lake OzarkLake Ozark, MO, CCN 268711 Rural health clinic Corporate Director Jun 6, 2024
Lake Regional Clinic-LaurieGravois Mills, MO, CCN 268708 Rural health clinic Corporate Director Jun 6, 2024
Lake Regional Clinic-EldonEldon, MO, CCN 268705 Rural health clinic Corporate Director Jun 6, 2024
Lake Regional Clinic-LebanonLebanon, MO, CCN 268785 Rural health clinic Corporate Director Jun 6, 2024
Lake Regional Obstetrics & GynecologyOsage Beach, MO, CCN 268786 Rural health clinic Corporate Director Jun 6, 2024
Lake Regional Express Care - CamdentonCamdenton, MO, CCN 268787 Rural health clinic Corporate Director Jun 6, 2024

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

Organizations & group practices 5

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1396837217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N KEENE ST",
            "address_2": "SUITE 301",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017193",
            "telephone_number": "573-449-0808",
            "fax_number": "573-442-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N KEENE ST",
            "address_2": "SUITE 301",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017193",
            "telephone_number": "573-449-0808",
            "fax_number": "573-442-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "WARREN",
        "middle_name": "TODD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "T2006017755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.