Cooper Nickels, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

010116 Issued in AZ

Practice address

1200 N Beaver St
Flagstaff, AZ 86001-3118

Phone

(928) 214-3930

Fax

(928) 214-3882

NPI assigned

May 20, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

76.21 of 100Reported as group

Quality

70.63

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Flagstaff Emergency Physicians

  • Emergency Medicine Physician
  • Flagstaff, AZ
  • NPI 1073683991

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1649893959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860020067",
            "telephone_number": "928-214-3930",
            "fax_number": "928-214-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-214-3930",
            "fax_number": "928-214-3882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "269 S Candy Ln",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "AZ",
            "postal_code": "863264170",
            "country_code": "US",
            "telephone_number": "928-214-3930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKELS",
        "first_name": "COOPER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-20",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "010116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Kim Nguyen
• Vy Nguyen, OTD
• Benjamin Nicholas
• Scott Nichols, DVM
• Scott Crandall Nicholson
• Janet Marie Nicks, RN, CNOR, RNFA, NP-C
• Bradley Robert Nicol, MD
• Jeremy Nielsen, M.D.
• Callie Rae Niemann, AUD
• Emily H Nieto, DMD, MPH

• Emergency Medicine Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.