Individual provider Active NPI

Ruthie S Cooper, MD

  • Child & Adolescent Psychiatry Physician
  • Indianapolis, IN
National Provider Identifier
1447612742
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
01088234A Issued in IN
Practice address
1002 Wishard Blvd Ste 4110
Indianapolis, IN 46202-4164
Phone
(317) 944-8162
Fax
(317) 948-0609
NPI assigned
Mar 25, 2016
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 28413 WV
Child & Adolescent Psychiatry Physician 2084P0804X 01088234A IN Primary

Addresses

Primary practice location

1002 Wishard Blvd Ste 4110
Indianapolis, IN 46202-4164

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1115 20th St # 205
Huntington, WV 25703
Phone (304) 691-1500

Other practice location 2

800 Rose St # C246
Lexington, KY 40536-7001
Phone (859) 323-6162

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rcooper@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211220001982 WV Practitioner - Psychiatry 6305237751 Reassigns benefits to 1 organization
I20220802002386 IN Practitioner - Psychiatry 6305237751 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28413WVMDPsychiatry Physician
01088234AINMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HHC River Park, Inc. CurrentSince Nov 19, 2021 Accepting new patients
HHC River Park, Inc. CurrentSince Nov 19, 2021 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Aug 1, 2022 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

1002 Wishard Blvd
Ste 4110
Indianapolis, IN 46202
Phone (317) 274-6450

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1230 6th Ave
Huntington, WV 25701
Phone (304) 526-9100

Organizations & group practices 4

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": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1447612742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 WISHARD BLVD STE 4110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462024164",
            "telephone_number": "317-944-8162",
            "fax_number": "317-948-0609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 20th St # 205",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "25703",
            "country_code": "US",
            "telephone_number": "304-691-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Rose St # C246",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405367001",
            "country_code": "US",
            "telephone_number": "859-323-6162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "RUTHIE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "28413",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IN",
            "license": "01088234A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcooper@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1002 Wishard Blvd Ste 4110",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462024164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.