Carnell Cooper, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

S1376 Issued in TX

Practice address

12709 Toepperwein Rd Ste 302
Live Oak, TX 78233

Phone

(210) 653-9307

Fax

(210) 653-7014

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD, SC2 enrollments

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ccooper6038@direct.umm.edu
• Direct secure messaging: carnell.cooper.1@24172.direct.athenahealth.com

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.

• Musc Community Physicians

  dba MUSC Community Physicians Specialty

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006

  Surgery

  Medicare reassignment NPD
• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment NPD
• Musc Community Physicians

  dba MUSC Health Primary Care - Bowman

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD
• Musc Community Physicians

  dba MUSC Community Physicians PC

  • Family Medicine Physician
  • Bamberg, SC
  • NPI 1992383145
  NPD
• University of Maryland Community Medical Group, Inc.

  • Psychiatry Physician
  • La Plata, MD
  • NPI 1679393854
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Grace Medical Center, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1962480772
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557014400000",
    "number": "1447287446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12709 TOEPPERWEIN RD STE 302",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333260",
            "telephone_number": "210-653-9307",
            "fax_number": "210-653-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12709 TOEPPERWEIN RD STE 302",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "78233",
            "telephone_number": "210-653-9307",
            "fax_number": "210-653-7014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-6704",
            "fax_number": "410-328-4124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 S Greene St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-6704",
            "fax_number": "410-328-4124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CARNELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2019-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D40386",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MD",
            "license": "D40386",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "S1376",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "S1376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071441100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Concentra Primary Care PA (Allied Institute of Medicine)
• Consultants in Pain Medicine PLLC
• Conviva Medical Center Management of Texas, P.a.
• Rebecca Laura Cook, DO
• Sarah R Cook, P.T.
• Mathilde Athenais Leontine Coquillaud-Salomon
• Sasha Cora, DC
• Yuni Corwin, APRN-CNP
• Phillip Dwight Cosby, PHYSICIAN ASSISTANT
• Council Oaks Community Options

• Surgery Physician in Live Oak, TX
• Providers in Live Oak, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.