Cooper Family Medicine PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COOPER FAMILY MEDICINE PC

Practice address

1001 Lincoln Dr W Ste F
Marlton, NJ 08053-1534

Phone

(856) 810-1800

Fax

(856) 810-1879

NPI assigned

Jun 11, 2007

Last updated

May 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert McMullen

Title

Evp Managed Care

Phone

(856) 342-2921

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1467655902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 502",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2921",
            "fax_number": "856-968-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 LINCOLN DR W STE F",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531534",
            "telephone_number": "856-810-1800",
            "fax_number": "856-810-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EVP MANAGED CARE",
        "authorized_official_telephone_number": "856-342-2921"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH GRP#",
            "identifier": "0790979001",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6558101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Constellation Health Services NJ LLC (Constellation Hospice)
• Contemporary TMS of Marlton
• Brooke M. Convento, CRNA
• Ellen Mildred Convery, CRNA
• Cooper Family Medicine - Marlton
• Lukas Cooper, PA-C
• Kelli L Copeland, PA
• Tasha S Coplon
• Ethel Coppa, SLP-CCC
• Megan Corello, LCSW

• Family Medicine Physician in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.