Individual provider Active NPI

Kyle Lee Cooper, PT

  • Orthopedic Physical Therapist
  • Chapel Hill, NC
National Provider Identifier
1629341698
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
13370 Issued in NC
Practice address
100 Sprunt St
Room 127
Chapel Hill, NC 27517-7811
Phone
(984) 974-2560
Fax
(919) 843-2195
NPI assigned
Feb 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 13370 NC Primary
Physical Therapist 225100000X P13370 NC

Addresses

Primary practice location

100 Sprunt St
Room 127
Chapel Hill, NC 27517-7811

Mailing address

101 Manning Dr
Department of PT/OT
Chapel Hill, NC 27514-4220
Phone (984) 974-2560

Other practice location 1

7100 Kit Creek Rd Bldg 9
Morrisville, NC 27560-8663
Phone (919) 392-2002

Other identifiers 1

IdentifierTypeStateIssuer
Q40934E107OtherNCMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcooper138535@direct.UNC.nchie.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121011000440 NC Practitioner - Physical Therapist in Private Practice 2769631530 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proaxis Therapy SC, LLC Physical Therapist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kcooper138535@direct.unc.nchie.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1629341698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "address_2": "DEPARTMENT OF PT/OT",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "984-974-2560",
            "fax_number": "919-843-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPRUNT ST",
            "address_2": "ROOM 127",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275177811",
            "telephone_number": "984-974-2560",
            "fax_number": "919-843-2195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7100 Kit Creek Rd Bldg 9",
            "address_purpose": "LOCATION",
            "city": "Morrisville",
            "state": "NC",
            "postal_code": "275608663",
            "country_code": "US",
            "telephone_number": "919-392-2002",
            "fax_number": "984-215-2951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KYLE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "13370",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P13370",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Q40934E107",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcooper138535@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "7100 Kit Creek Rd Bldg 9",
            "city": "Morrisville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275608663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.