Individual provider Active NPI

Roman B Cooper, D.C.

  • Chiropractor
  • Cayce, SC
National Provider Identifier
1609942192
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2248 Issued in SC
Practice address
1106 12TH St
Cayce, SC 29033-3305
Phone
(803) 796-2424
Fax
(803) 791-4076
NPI assigned
Nov 27, 2006
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2248 SC Primary

Addresses

Primary practice location

1106 12TH St
Cayce, SC 29033-3305

Mailing address

1106 12TH St
Cayce, SC 29033-3305
Phone (803) 796-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041230000529 SC Practitioner - Chiropractic 7113985532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cayce Chiropractic CenterGroup PAC ID 6204916273, 2 clinicians

Practice addresses (Care Compare)

1106 12TH St
Cayce, SC 29033-3305
Phone (803) 796-2424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2248SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cayce Chiropractic Center Chiropractor CurrentSince Dec 4, 2007 Accepting new patients

Locations

1106 12th St
Cayce, SC 29033
Phone (803) 796-2424

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1609942192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 12TH ST",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290333305",
            "telephone_number": "803-796-2424",
            "fax_number": "803-791-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 12TH ST",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290333305",
            "telephone_number": "803-796-2424",
            "fax_number": "803-791-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ROMAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayce, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.