Individual provider Active NPI

Beth Cooper, DC

  • Chiropractor
  • Oakland Park, FL
National Provider Identifier
1447215413
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
OOO7727 Issued in FL
Practice address
3436 N Andrews Ave
Oakland Park, FL 33309-6060
Phone
(954) 390-0818
Fax
(954) 390-0817
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
Yes

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 OOO7727 FL Primary

Addresses

Primary practice location

3436 N Andrews Ave
Oakland Park, FL 33309-6060

Mailing address

3436 N Andrews Ave
Oakland Park, FL 33309-6060
Phone (954) 390-0818

Other identifiers 2

IdentifierTypeStateIssuer
55873OtherFLBLUE CROSS BLUE SHIELD
P00162652OtherFLRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050304000245 FL Practitioner - Chiropractic 5799739603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

120 E Oakland Park Blvd
Suite 106
Oakland Park, FL 33334-1106
Phone (954) 390-0818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OOO7727FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Cooper DC PA Chiropractor CurrentSince Oct 1, 2004 Accepting new patients

Locations

3436 N Andrews Ave
Oakland Park, FL 33309
Phone (954) 390-0818

120 E Oakland Park Blvd
Ste 106
Oakland Park, FL 33334
Phone (954) 390-0818

Interoperability endpoints

  • Direct secure messaging: beth.cooper.1@14958.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447215413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 N ANDREWS AVE",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333096060",
            "telephone_number": "954-390-0818",
            "fax_number": "954-390-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 N ANDREWS AVE",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333096060",
            "telephone_number": "954-390-0818",
            "fax_number": "954-390-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "OOO7727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "55873",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00162652",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

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.