Individual provider Active NPI

Robert A Cooper, M.D.

  • Specialist
  • Melbourne, FL
National Provider Identifier
1578566212
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0046874 Issued in FL
Practice address
1341 Medical Park Dr
Ste 201
Melbourne, FL 32901-3235
Phone
(321) 953-1225
Fax
(321) 768-0033
NPI assigned
May 26, 2005
Last updated
Jan 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0046874 FL Primary

Addresses

Primary practice location

1341 Medical Park Dr
Ste 201
Melbourne, FL 32901-3235

Mailing address

1341 Medical Park Dr
Ste 201
Melbourne, FL 32901-3235
Phone (321) 953-1225

Other identifiers 1

IdentifierTypeStateIssuer
260898700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: rcooper@aog.directglo.com

NPI Registry JSON

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

{
    "created_epoch": "1117065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1578566212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 MEDICAL PARK DR",
            "address_2": "STE 201",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013235",
            "telephone_number": "321-953-1225",
            "fax_number": "321-768-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 MEDICAL PARK DR",
            "address_2": "STE 201",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013235",
            "telephone_number": "321-953-1225",
            "fax_number": "321-768-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-26",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0046874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260898700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.