Justin R Cooper, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

71003003A Issued in IN

Practice address

2400 17TH St
Columbus, IN 47201-5351

Phone

(812) 376-5757

Fax

(812) 376-5058

NPI assigned

Apr 30, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbus Regional Health Physicians LLCGroup PAC ID 1052612314, 216 clinicians

St Francis Medical Group LLCGroup PAC ID 7012067697, 113 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Columbus Regional Hospital Hospital, Columbus, IN, CCN 150112
• Franciscan Health Indianapolis Hospital, Indianapolis, IN, CCN 150162
• Ascension St Vincent Jennings Hospital, North Vernon, IN, CCN 151303

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcooper11513@edirect.crh.org
• Direct secure messaging: jcooper526034@direct.franciscanalliance.org
• Direct secure messaging: direct.indianainternalmedicine@ccme.com

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.

• Columbus Regional Health Physicians, LLC

  • Internal Medicine Physician
  • Columbus, IN
  • NPI 1336510098

  Acute Care

  Medicare reassignment Care Compare group NPD
• St. Francis Medical Group, LLC

  • Internal Medicine Physician
  • Greenwood, IN
  • NPI 1467693135

  Acute Care

  Medicare reassignment Care Compare group NPD
• Indiana Internal Medicine Consultants, LLC.

  • Internal Medicine Physician
  • Greenwood, IN
  • NPI 1609834357

  Acute Care

  Medicare reassignment NPD
• Columbus Regional Health Physicians, LLC

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1740650225
  NPD
• St Francis Medical Group LLC

  • Internal Medicine Physician
  • Monroe, LA
  • NPI 1134405087
  NPD
• Columbus Regional Health Physicians, LLC

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1902276488
  NPD (past)

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

• Columbus Regional Hospital

  • General Acute Care Hospital
  • Columbus, IN
  • NPI 1104998624
  Care Compare affiliation
• Franciscan Health Indianapolis & Mooresville

  • General Acute Care Hospital
  • Carmel, IN
  • NPI 1376214981
  Care Compare affiliation
• Franciscan Health Indianapolis & Mooresville

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1386749893
  Care Compare affiliation
• St. Vincent Jennings Hospital, Inc.

  • Critical Access Hospital
  • North Vernon, IN
  • NPI 1285684829
  Care Compare affiliation

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1710121959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 17TH ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015351",
            "telephone_number": "812-376-5757",
            "fax_number": "812-376-5058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 E County Line Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461431070",
            "country_code": "US",
            "telephone_number": "317-885-2860",
            "fax_number": "317-885-2869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JUSTIN",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-30",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "IN",
            "license": "71003003A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71003003A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201112920",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct.indianainternalmedicine@ccme.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "701 E County Line Rd Ste 101",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcooper11503@edirect.crh.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2400 17th St",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472015351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jared R Compton, DPT
• Cheryl A Conetsco, DO
• Kristi M. Conner, AU.D.
• Nicole Rene Cook, M.S. CCC-SLP
• Jordanne Cooper, LCSW
• Rachel Brook Cooper
• Anna Corder
• Cornerstone Caregiving East LLC
• Katelin Couch
• Cove Direct Primary Care, LLC

• Acute Care Nurse Practitioner in Columbus, IN
• Providers in Columbus, IN by specialty
• Acute Care Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.