Active NPI
Cooper Clinic PA
- Clinic/Center
- Fort Smith, AR
National Provider Identifier
1477575181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- MC-0254
- Legal business name
- COOPER CLINIC PA
- Practice address
- 7001 Rogers Ave
Fort Smith, AR 72903-4073 - Phone
- (479) 274-2000
- Fax
- (479) 274-2194
- NPI assigned
- Jul 24, 2006
- Last updated
- Sep 1, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Curtis D Ralston
- Title
- Ceo
- Phone
- (479) 274-2000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | MC-0254 | AR | Primary |
Addresses
Primary practice location
7001 Rogers Ave
Fort Smith, AR 72903-4073
Mailing address
PO Box 3528
Fort Smith, AR 72913-3528
Phone (479) 274-2000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C50280 | Other | RR MEDICARE | |
| 125042002 | Medicaid | AR |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1441065600000",
"number": "1477575181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3528",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729133528",
"telephone_number": "479-274-2000",
"fax_number": "479-274-2194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7001 ROGERS AVE",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729034073",
"telephone_number": "479-274-2000",
"fax_number": "479-274-2194"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COOPER CLINIC PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-24",
"last_updated": "2015-09-01",
"status": "A",
"authorized_official_last_name": "RALSTON",
"authorized_official_first_name": "CURTIS",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "479-274-2000"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "AR",
"license": "MC-0254",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "C50280",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "125042002",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.