NPIMap

Organization Active NPI

Carl J Cooper MD PC

  • Internal Medicine Physician
  • Savannah, GA
National Provider Identifier
1437185170
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40352 Issued in GA
Legal business name
CARL J COOPER MD PC
Practice address
823 E 66TH St
Savannah, GA 31405-4507
Phone
(912) 691-0603
Fax
(912) 354-8484
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Carl Jerome Cooper, MDNPI 1699725713
Title
Physician/Owner
Phone
(912) 691-0603

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 40352 GA Primary

Addresses

Primary practice location

823 E 66TH St
Savannah, GA 31405-4507

Mailing address

PO Box 22183
Savannah, GA 31403-2183
Phone (912) 691-0603

Other identifiers 1

IdentifierTypeStateIssuer
00680314EMedicaidGA

Other names 1

  • COOPER MEDICAL GROUP ASSOCIATES Doing business as

National Provider Directory

National Provider Directory

Locations

823 E 66th St
Savannah, GA 31405
Phone (912) 691-0603

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1437185170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22183",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314032183",
            "telephone_number": "912-691-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 E 66TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054507",
            "telephone_number": "912-691-0603",
            "fax_number": "912-354-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL J COOPER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "912-691-0603",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "40352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00680314E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COOPER MEDICAL GROUP ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.