Vidette V Cooper, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

22230 Issued in SC

Practice address

803 Tilghman Dr
Suite 100
Dunn, NC 28334-5509

Phone

(910) 892-1091

Fax

(910) 892-1097

NPI assigned

May 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Carolinas Medical Alliance, Inc

  • Rural Health Clinic/Center
  • Pamplico, SC
  • NPI 1023238490
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1568420107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 TILGHMAN DR",
            "address_2": "SUITE 100",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345509",
            "telephone_number": "910-892-1091",
            "fax_number": "910-892-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 TILGHMAN DR",
            "address_2": "SUITE 100",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345509",
            "telephone_number": "910-892-1091",
            "fax_number": "910-892-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "VIDETTE",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "22230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909335",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "GP4840",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T64356",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764356",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "GP4306",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "GP1883",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Service Network, Inc
• Commwellhealth
• Andrea Compton, M.A., LCMHCA
• Caroline Cook
• Adrianne Beth Cool
• Core Family Care Inc.
• Sallie Elliott Corse, PA-C
• Gwendolyn Christanne Coxum
• Ryan Craddock, CADC, LCAS-A
• Jacqueline Ann Crete, MSED., CCC-SLP

• Internal Medicine Physician in Dunn, NC
• Providers in Dunn, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.