Gary Scott Cooper, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA15219 Issued in CA

Practice address

283 Madonna Rd
Suite B
San Luis Obispo, CA 93405-5432

Phone

(805) 549-8880

Fax

(805) 549-8743

NPI assigned

Mar 16, 2007

Last updated

Jul 10, 2007By the provider in NPPES

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Kristopher Lyon, MD & Rachel May, MD, a Medical Corporation

  • Urgent Care Clinic/Center
  • San Luis Obispo, CA
  • NPI 1497572804
  Medicare reassignment
• Med-Stops Medical Clinic, Inc.

  • Emergency Care Clinic/Center
  • San Luis Obispo, CA
  • NPI 1295718849
  Medicare reassignment

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1598889735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 MADONNA RD",
            "address_2": "SUITE B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055432",
            "telephone_number": "805-549-8880",
            "fax_number": "805-549-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 MADONNA RD",
            "address_2": "SUITE B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055432",
            "telephone_number": "805-549-8880",
            "fax_number": "805-549-8743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "GARY",
        "middle_name": "SCOTT",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA15219",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Cook
• Terri Lynne Cook, LPT
• Christopher Robert Cooke
• Derek L Coombs, O.D.
• Barry Bo Cooper
• Laura Cooper, OTR/L
• Olivia Claire Cooper
• Patricia Ann Cooper I
• James G. Coopman, P.T.
• Koral Eszti Coopwood

• Physician Assistant in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.