Melanie L Cooper, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

045753 Issued in GA

Practice address

578 S Enota Dr NE Ste C
Gainesville, GA 30501-8947

Phone

(470) 290-8474

NPI assigned

May 23, 2006

Last updated

Jul 31, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Family PracticeAlso: Emergency Medicine, Undersea and Hyperbaric Medicine

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Calixto J Cornavaca Diaz MD LLCGroup PAC ID 2961756432, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Calixto J Cornavaca Diaz MD LLC

  dba Cornavaca Clinic

  • General Practice Physician
  • Gainesville, GA
  • NPI 1487140349
  Medicare reassignment Care Compare group NPD
• Wound Care & Hyperbaric Center

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Lithonia, GA
  • NPI 1205370632
  NPD
• GVS Healthcare Clinics LLC

  • General Practice Physician
  • Atlanta, GA
  • NPI 1508389578
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1669427316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 S ENOTA DR NE STE C",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305018947",
            "telephone_number": "470-290-8474",
            "fax_number": "770-593-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 S ENOTA DR NE STE C",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305018947",
            "telephone_number": "470-290-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MELANIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "GA",
            "license": "045753",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "045753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000800588K",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Cooley, PHARMD
• Anna Catherine Cooper, PHARMD
• Ashley Cooper, AAC
• Darin J. Cooper, P.A.
• Lynn Michelle Cooper, P.A.
• Sarah Lindsey Cope, LMSW
• Chad Michael Copper, MD
• Jordan Cordova, CAA
• Core Billing Solutions LLC
• Michael Thomas Cormican, MD

• Family Medicine Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.