Ronald Olaf Cooper, DC
Individual provider Active NPI Chiropractor · W Somerset, KY
NPI 1497769806 · NPPES record last updated Aug 10, 2010
Key facts
- NPI
- 1497769806
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3667R (KY)
- Practice address
- 1005 W Columbia St
W Somerset, KY 42503 - Phone
- (606) 679-1166
- Fax
- (606) 679-1167
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1005 W Columbia St
Somerset, KY 42503-2720
Phone (606) 679-1166
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101022000476 | KY | Practitioner - Chiropractic | 5799778668 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3667R | KY | MD | Chiropractor |
| CH00034749 | WA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cooper & Cooper, PSC | Chiropractor | Current |
Accepting new patients |
Locations
1005 W Columbia St
Somerset, KY 42503
Phone (606) 679-1166
106 Lake Ave S
Renton, WA 98057
Phone (425) 235-9901
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3667R | KY | Yes |
Addresses
Primary practice location
1005 W Columbia St
W Somerset, KY 42503
Mailing address
PO Box 3334
W Somerset, KY 42564
Phone (606) 679-1166
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 406350766 | Other | RRMC | |
| 85036671 | Medicaid | KY | |
| 000000046993 | Other | ANTHEM |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.