Individual provider Active NPI

Kathryn H Cooper, CRNA

  • Certified Registered Nurse Anesthetist
  • Decatur, AL
National Provider Identifier
1407995798
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
44289 Issued in AL
Practice address
1874 Beltline Rd SW
Decatur, AL 35601-5514
Phone
(256) 301-3340
Fax
(256) 301-3443
NPI assigned
Feb 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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
Certified Registered Nurse Anesthetist 367500000X 44289 AL Primary

Addresses

Primary practice location

1874 Beltline Rd SW
Decatur, AL 35601-5514

Mailing address

157 County Road 378
Trinity, AL 35673-5346
Phone (256) 355-5169

Other identifiers 2

IdentifierTypeStateIssuer
042380OtherALRN LICENSE
44289OtherALCRNA LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070806000320 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466543459 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44289ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Crna Services of DGH Nurse Anesthetist, Certified Registered CurrentSince May 6, 2011 Accepting new patients
National Healthcare of Decatur Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Northstar Anesthesia of Alabama, LLC Past Accepting new patients

Locations

1201 7th St SE
Decatur, AL 35601
Phone (256) 341-2000

1874 Beltline Rd SW
Decatur, AL 35601
Phone (256) 301-2211

Organizations & group practices 3

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407995798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 COUNTY ROAD 378",
            "city": "TRINITY",
            "state": "AL",
            "postal_code": "356735346",
            "telephone_number": "256-355-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1874 BELTLINE RD SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356015514",
            "telephone_number": "256-301-3340",
            "fax_number": "256-301-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KATHRYN",
        "middle_name": "H",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "44289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "042380",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA LICENSE",
            "identifier": "44289",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.