Kerry Dale Cooper

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

155 Bimini PL
Los Angeles, CA 90004-5902

Phone

(213) 388-5423

NPI assigned

Oct 15, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1639832793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4847 VISTA DE ORO AVE",
            "city": "VIEW PARK",
            "state": "CA",
            "postal_code": "900431610",
            "telephone_number": "323-601-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BIMINI PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045902",
            "telephone_number": "213-388-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KERRY",
        "middle_name": "DALE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-15",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Cooper, D.O.
• Joseph Cooper, M.D.
• Joseph Paul Anthony Cooper, FNP-C
• Kayla Rosalyn Cooper, PA-C
• Kelly Cooper
• Khidell Cooper
• Lanae Cooper
• Leroy Cooper, P.A.
• Mark Anthony Cooper Jr.
• Martin Cooper, M.D.

• Addiction (Substance Use Disorder) Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.