Everett Cordie Cooper III, M.D.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

46394 Issued in FL

Practice address

CHS-005
Kennedy Space Center, FL 32899

Phone

(321) 861-8638

NPI assigned

Apr 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457571630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 INDIAN CREEK DR",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329312834",
            "telephone_number": "321-783-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHS-005",
            "city": "KENNEDY SPACE CENTER",
            "state": "FL",
            "postal_code": "32899",
            "telephone_number": "321-861-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "EVERETT",
        "middle_name": "CORDIE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "46394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adventist Health System/Sunbelt, Inc. (Kennedy Space Center Visitor Complex First Aid Station)
• John Joseph Darwood, M.D.
• Frederick Allen Hauser Jr., D.O. MPH
• Mary Kathleen Kirkland, MS, ATC, LAT, CSCS
• Violette W Salib, M.D.
• Ian Christopher Stites, LAT, ATC

• Critical Care Medicine (Internal Medicine) Physician in Kennedy Space Center, FL
• Providers in Kennedy Space Center, FL by specialty
• Critical Care Medicine (Internal Medicine) Physician in Florida

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.