NPIMap

Organization Active NPI

Cooper Pediatric Specialists

  • Pediatrics Physician
  • Camden, NJ
National Provider Identifier
1497888689
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
COOPER PEDIATRIC SPECIALISTS
Practice address
3 Cooper PLZ
Suite 200
Camden, NJ 08103-1438
Phone
(856) 342-2001
NPI assigned
Mar 14, 2007
Last updated
Aug 30, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
COOPER PEDIATRIC SPECIALISTSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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) 342-7263

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X NU
Pediatrics Physician 208000000X NU Primary
Pediatric Gastroenterology Physician 2080P0206X NU

Addresses

Primary practice location

3 Cooper PLZ
Suite 200
Camden, NJ 08103-1438

Mailing address

3 Cooper PLZ
Suite 502
Camden, NJ 08103-1438
Phone (856) 968-7433

Other identifiers 2

IdentifierTypeStateIssuer
2125255000OtherAMERIHEALTH GRP NUMBER
9024603MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Cooper Pediatric Specialists15 organizations share this tax ID, including this one
Part of
Cooper Pediatric Specialists

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

3 Cooper Plz
Rm 200
Camden, NJ 08103
Phone (609) 342-2001

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1497888689",
    "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": "856-968-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER PEDIATRIC SPECIALISTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COOPER PEDIATRIC SPECIALISTS",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EVP MANAGED CARE",
        "authorized_official_telephone_number": "856-342-7263"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH GRP NUMBER",
            "identifier": "2125255000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9024603",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.

Verify at the official NPI Registry.