Carmen Cooper, MA

Primary specialty

TechnicianTaxonomy code 374700000X

License

S5J3S5Q8 Issued in GA

Practice address

933 N Hairston Rd Ste 4
Stone Mountain, GA 30083-2850

Phone

(404) 500-0087

NPI assigned

Oct 16, 2023

Sex

Female

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

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• LTCC Enterprises LLC

  • Phlebotomy Technician
  • Stone Mountain, GA
  • NPI 1508648536
  NPD Authorized official

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1639951668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 N HAIRSTON RD STE 4",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300832850",
            "telephone_number": "404-500-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 N HAIRSTON RD STE 4",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300832850",
            "telephone_number": "404-500-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CARMEN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "GA",
            "license": "S5J3S5Q8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Comrie, RN
• Concoh Health Care
• Connection Bridge Oasis, Inc.
• Christopher Connelly, D.C.
• Carla N Cooke, PA-C
• Jeniesha Cooper, LPN
• Tanisha Chantal Cooper, PHARMD.
• Della Corbin-Johnson, RPH
• Edward A Corkran, D.O.
• Ray Cornay, D.M.D.

• Technician in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.