Active NPI
Derek A Cooze, MD
- Family Medicine Physician
- Morristown, TN
National Provider Identifier
1710937701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD17188
- Practice address
- 420 W Morris Blvd
Health Star Physicians Ste 400B
Morristown, TN 37813 - Phone
- (423) 586-2410
- Fax
- (423) 581-9692
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD17188 | TN | Primary |
Addresses
Primary practice location
420 W Morris Blvd
Health Star Physicians Ste 400B
Morristown, TN 37813
Mailing address
420 W Morris Blvd
Health Star Physicians Ste 400B
Morristown, TN 37813
Phone (423) 586-2410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3020050 | Medicaid | TN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | derek.cooze.1@3525.direct.athenahealth.com | Direct |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD17188 | TN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641772800000",
"number": "1710937701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 W MORRIS BLVD",
"address_2": "HEALTH STAR PHYSICIANS STE 400B",
"city": "MORRISTOWN",
"state": "TN",
"postal_code": "37813",
"telephone_number": "423-586-2410",
"fax_number": "423-581-9692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 W MORRIS BLVD",
"address_2": "HEALTH STAR PHYSICIANS STE 400B",
"city": "MORRISTOWN",
"state": "TN",
"postal_code": "37813",
"telephone_number": "423-586-2410",
"fax_number": "423-581-9692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOZE",
"first_name": "DEREK",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2022-01-10",
"certification_date": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "MD17188",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3020050",
"state": "TN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "derek.cooze.1@3525.direct.athenahealth.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "420 W Morris Blvd",
"address_2": "Health Star Physicians Ste 400B",
"city": "Morristown",
"state": "TN",
"country_code": "US",
"postal_code": "37813",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Morristown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.