Active NPI
Robert Cooper, MD
- Anesthesiologist Assistant
- Atlanta, GA
National Provider Identifier
1467537878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- R11528
- Practice address
- 1364 Clifton Rd
Atlanta, GA 30322 - Phone
- (404) 778-4852
- NPI assigned
- Oct 25, 2006
- 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 |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | R11528 | GA | Primary |
Addresses
Primary practice location
1364 Clifton Rd
Atlanta, GA 30322
Mailing address
2254 E Lake Rd NE
Atlanta, GA 30307-1838
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00399308B | Medicaid | GA |
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
- Credentials
- Associate of Arts, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R11528 | GA | MD | Anesthesiologist Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467537878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2254 E LAKE RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303071838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1364 CLIFTON RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30322",
"telephone_number": "404-778-4852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "GA",
"license": "R11528",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00399308B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- 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.