Active NPI
Matthew James Cool
- Military Health Care Provider
- Virginia Beach, VA
National Provider Identifier
1447964614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- Practice address
- 472 Polaris St BLDG 586
Virginia Beach, VA 23461-1935 - Phone
- (757) 862-0060
- NPI assigned
- Jan 11, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | Primary |
Addresses
Primary practice location
472 Polaris St BLDG 586
Virginia Beach, VA 23461-1935
Mailing address
472 Polaris St BLDG 586
Virginia Beach, VA 23461-1935
Phone (757) 862-0060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437528940 | Other | DEPARTMENT OF DEFENSE TRICARE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | genesis | Direct | |
| Other URL | genesis | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1447964614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "472 POLARIS ST BLDG 586",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234611935",
"telephone_number": "757-862-0060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "472 POLARIS ST BLDG 586",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234611935",
"telephone_number": "757-862-0060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOL",
"first_name": "MATTHEW",
"middle_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-11",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF DEFENSE TRICARE",
"identifier": "1437528940",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "genesis",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"useOtherDescription": "genesis",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "genesis",
"address_1": "472 Polaris St Bldg 586",
"city": "Virginia Beach",
"state": "VA",
"country_code": "US",
"postal_code": "234611935",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "genesis",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "genesis",
"address_1": "472 Polaris St Bldg 586",
"city": "Virginia Beach",
"state": "VA",
"country_code": "US",
"postal_code": "234611935",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.