NPIMap

Individual provider Active NPI

Everett Michael Cooper

  • Internal Medicine Physician
  • Vincennes, IN
National Provider Identifier
1558948828
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01093752A Issued in IN
Practice address
520 S 7TH St
Vincennes, IN 47591-1038
Phone
(812) 885-8520
NPI assigned
Mar 24, 2021
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01093752A IN Primary

Addresses

Primary practice location

520 S 7TH St
Vincennes, IN 47591-1038

Mailing address

1353 Waterston Dr
Evans, GA 30809-5038
Phone (706) 836-1330

Other practice location 1

3700 Washington Ave
Evansville, IN 47714-0541
Phone (812) 485-7040

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address everett.cooper.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709002466 IN Practitioner - Internal Medicine 3577965995 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians
Apogee Medical Group Indiana PCGroup PAC ID 8729155742, 70 clinicians

Practice addresses (Care Compare)

3700 Washington Ave
Evansville, IN 47714-0541
Phone (812) 485-4000

520 S 7TH St
Vincennes, IN 47591-1038
Phone (812) 882-5220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
83.98
Improvement activities
40
Cost
76.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01093752AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Indiana PC Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
St Mary's Medical Group, LLC Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
St Mary's Medical Group, LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280

Interoperability endpoints

  • Direct secure messaging: ecooper225348@direct.deaconess.com
  • Direct secure messaging: everett.cooper.1@7598.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1558948828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 WATERSTON DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308095038",
            "telephone_number": "706-836-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S 7TH ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911038",
            "telephone_number": "812-885-8520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477140541",
            "country_code": "US",
            "telephone_number": "812-485-7040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "EVERETT",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01093752A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "everett.cooper.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "3700 Washington Ave",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477140541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.