Tom Cooper, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5906659-4405 Issued in UT

Practice address

3802 S 700 E
Salt Lake City, UT 84106-1182

Phone

(801) 264-6000

NPI assigned

Jul 23, 2017

Last updated

Sep 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salt Lake Behavioral Health LLCGroup PAC ID 6709915473, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Salt Lake Behavioral Health, LLC

  dba Salt Lake Behavioral Health

  • Psychiatric Hospital
  • Salt Lake City, UT
  • NPI 1295066116
  Medicare reassignment Care Compare group NPD
• Salt Lake Behavioral Health, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Salt Lake City, UT
  • NPI 1689037566
  NPD
• Benchmark Behavioral Health System Inc

  • Psychiatric Residential Treatment Facility
  • Woods Cross, UT
  • NPI 1598772618
  NPD (past)

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1487177382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4754 S APPLE CROSS WAY",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841073771",
            "telephone_number": "801-918-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061182",
            "telephone_number": "801-264-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "TOM",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-23",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "5906659-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "5906659-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn N Cooper, CCC-SLP
• Shawn Richard Cooper, L.P.C.
• Stephanie Ann Cooper, MFT INTERN
• Taylor Cooper
• Thomas Patrick Cooper
• Troy Dillon Cooper
• Jensen Cope
• Merrily S. Cope, LCSW
• Spencer Richard Cope, MD
• Copper Valley Integrated Health LLC

• Psychiatric/Mental Health Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.