NPIMap

Organization Active NPI

Cooper Surgical Asscociates

  • Pediatric Surgery Physician
  • Camden, NJ
National Provider Identifier
1649463696
Registry record updated Aug 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
Legal business name
COOPER SURGICAL ASSCOCIATES
Practice address
3 Cooper PLZ
Suite 411
Camden, NJ 08103-1438
Phone
(856) 342-3250
NPI assigned
Aug 23, 2007
Last updated
Aug 23, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
COOPER SURGICAL ASSCOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 23, 2007

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

Authorized official

Name
Robert McMullen
Title
Evp - Managed Care
Phone
(856) 968-7263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X Primary

Addresses

Primary practice location

3 Cooper PLZ
Suite 411
Camden, NJ 08103-1438

Mailing address

3 Cooper PLZ
Sutie 502
Camden, NJ 08103-1438
Phone (856) 968-7433

Other identifiers 2

IdentifierTypeStateIssuer
2843948000OtherNJAMERIHEALTH/KEYSTONE/IBC
2865807MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Cooper Surgical Assoc PA31 organizations share this tax ID, including this one
Part of
Cooper Surgical Assoc PA

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187827200000",
    "number": "1649463696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUTIE 502",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-968-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 411",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER SURGICAL ASSCOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COOPER SURGICAL ASSCOCIATES",
        "enumeration_date": "2007-08-23",
        "last_updated": "2007-08-23",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EVP - MANAGED CARE",
        "authorized_official_telephone_number": "856-968-7263"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/KEYSTONE/IBC",
            "identifier": "2843948000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2865807",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.