Individual provider Active NPI

Danielle Cooper, PA-C

  • Surgical Physician Assistant
  • Kettering, OH
National Provider Identifier
1457216392
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.009895RX Issued in OH
Practice address
3700 Southern Blvd Ste 300
Kettering, OH 45429-1265
Phone
(937) 643-9299
NPI assigned
Dec 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.009895RX OH Primary

Addresses

Primary practice location

3700 Southern Blvd Ste 300
Kettering, OH 45429-1265

Mailing address

3700 Southern Blvd Ste 300
Kettering, OH 45429-1265
Phone (937) 649-9299

Other practice location 1

425 W Grand Ave Ste 1003
Dayton, OH 45405-4776
Phone (937) 643-9299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260122001449 OH Practitioner - Physician Assistant 9032696927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern College of Osteo Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3700 Southern Blvd
Suite 300
Kettering, OH 45429-1265
Phone (937) 558-3214

Hospital & facility affiliations

  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50.009895RXOHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Feb 12, 2026 Accepting new patients

Locations

425 W Grand Ave
Ste 1003
Dayton, OH 45405
Phone (937) 226-7898

3700 Southern Blvd
Ste 300
Kettering, OH 45429
Phone (937) 395-8002

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1766448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1457216392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 SOUTHERN BLVD STE 300",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291265",
            "telephone_number": "937-649-9299",
            "fax_number": "937-643-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 SOUTHERN BLVD STE 300",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291265",
            "telephone_number": "937-643-9299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 W Grand Ave Ste 1003",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454054776",
            "country_code": "US",
            "telephone_number": "937-643-9299",
            "fax_number": "937-643-2343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-23",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.009895RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.