Jon H Cooperrider II, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4014/T214 Issued in OH

Practice address

484 Park Ave W
Mansfield, OH 44906-3118

Phone

(419) 525-0330

Fax

(419) 525-3362

NPI assigned

Sep 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcooperriderii152238@direct.ccf.org

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD
• Euclid Hospital Cleveland Clinic Health System

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD
• The Cleveland Clinic Foundation

  • Optometrist
  • Mansfield, OH
  • NPI 1568458925
  NPD (past)

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1730175829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063118",
            "telephone_number": "419-525-0330",
            "fax_number": "419-525-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063118",
            "telephone_number": "419-525-0330",
            "fax_number": "419-525-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPERRIDER",
        "first_name": "JON",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4014/T214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0893332",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sequoya Cooke
• Alison Marie Coole, RD,LD
• Crystal Lee Cooper, LPN
• Jennifer Diane Cooper
• Kristin Elyse Cooper, NP-C
• Randi Cordial
• Christie Ann Core
• Cynthia Ann Cornell, OTR L
• Loretta M. Cornell, R.N., M.S.N.
• Vickie Stolpa Cornell

• Optometrist in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.