Individual provider Active NPI

Cooper Blazek, MD

  • Family Medicine Physician
  • Huntersville, NC
National Provider Identifier
1659013340
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2025-01811 Issued in NC
Practice address
16645 Birkdale Commons Pkwy # 100a
Huntersville, NC 28078-5669
Phone
(170) 480-1739
NPI assigned
Apr 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2025-01811 NC Primary

Addresses

Primary practice location

16645 Birkdale Commons Pkwy # 100a
Huntersville, NC 28078-5669

Mailing address

5761 Cedermere Drive
Winston Salem, NC 27106
Phone (336) 688-6012

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251021001013 NC Practitioner - Family Practice 3173909926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrium Health North Market Network LLCGroup PAC ID 1557743440, 158 clinicians

Practice addresses (Care Compare)

4815 Johnston Oehler Rd
Suite 100
Charlotte, NC 28269-1065
Phone (704) 801-7310

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001
  • Atrium Health University City Hospital, Charlotte, NC, CCN 340166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2025-01811NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrium Health North Market Network LLC Family Medicine CurrentSince Oct 6, 2025 Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients

Locations

4525 Cameron Valley Pkwy
Ste 4100D
Charlotte, NC 28211
Phone (704) 801-7310

4815 Johnston Oehler Rd
#100
Charlotte, NC 28269
Phone (704) 801-7310

16645 Birkdale Commons Pkwy
Ste 100
Huntersville, NC 28078
Phone (704) 801-7390

Interoperability endpoints

  • Direct secure messaging: cblazek816627@carolinashealthcaresystem.direct-ci.com

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1659013340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5761 CEDERMERE DRIVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27106",
            "telephone_number": "336-688-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16645 BIRKDALE COMMONS PKWY # 100A",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785669",
            "telephone_number": "170-480-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZEK",
        "first_name": "COOPER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-12",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2025-01811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.