Active NPI
James Robert Cooper, PTA
- Early Intervention Provider Agency
- Bridgeport, WV
National Provider Identifier
1689412306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- Practice address
- 305 Pearcy Ave
Bridgeport, WV 26330-1107 - Phone
- (304) 476-1021
- NPI assigned
- Jul 17, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 001018 | WV | |
| Early Intervention Provider Agency | 252Y00000X | Primary |
Addresses
Primary practice location
305 Pearcy Ave
Bridgeport, WV 26330-1107
Mailing address
305 Pearcy Ave
Bridgeport, WV 26330-1107
Phone (304) 476-1021
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001018 | WV | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1689412306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 PEARCY AVE",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "263301107",
"telephone_number": "304-476-1021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 PEARCY AVE",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "263301107",
"telephone_number": "304-476-1021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "JAMES",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-17",
"last_updated": "2024-11-07",
"certification_date": "2024-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WV",
"license": "001018",
"primary": false
},
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.