Christopher Cooper, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01271 Issued in TX

Practice address

855 Montgomery St
Fort Worth, TX 76107-2553

Phone

(817) 735-2363

Fax

(817) 735-2653

NPI assigned

Apr 17, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Shannon Clinic

  • Rural Health Clinic/Center
  • Ozona, TX
  • NPI 1245230465
  NPD (past)
• Shannon Clinic

  • Family Medicine Physician
  • San Angelo, TX
  • NPI 1770587149
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1790749570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99335",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990335",
            "telephone_number": "817-735-2363",
            "fax_number": "817-735-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MONTGOMERY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072553",
            "telephone_number": "817-735-2363",
            "fax_number": "817-735-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CHRISTOPHER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8N9187",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197090701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cooper Shoes Inc.
• Johnelle Suzanne Elizabeth Cooper-Lassiter, FNP
• Angela Denise Cooper, AGACNP-BC
• Ashley Cooper, RBT
• Charles Cooper
• Christopher Royce Cooper, M.D.
• Don E Cooper, C.PED.
• Janiya Cooper
• Keely B Cooper, FNP-C
• Mikyla Nan Cooper, MAT, LAT, ATC

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.