Randall Allen Cooper, D.P.M.

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

07000384A Issued in IN

Practice address

1723 E Bristol St
Elkhart, IN 46514-3968

Phone

(574) 264-7180

Fax

(574) 264-1875

NPI assigned

Jan 3, 2006

Last updated

Jan 27, 2010By the provider in NPPES

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

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elkhart Podiatry Clinic, P.C.

  • Podiatrist
  • Elkhart, IN
  • NPI 1437373677
  Authorized official Same address or phone

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1811975667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465143968",
            "telephone_number": "574-264-7180",
            "fax_number": "574-264-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465143968",
            "telephone_number": "574-264-7180",
            "fax_number": "574-264-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "RANDALL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IN",
            "license": "07000384A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RAILROAD MEDICARE",
            "identifier": "480010783",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112180",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha Liechty Conrad, M.S.W.
• Constance S. Stamper, MSW, Inc.
• Samantha Cook
• Donna Marie Cooper, FNP-C
• Lauren Cooper, LMHCA
• Zachary Corbin, RBT
• Core Fit Physical Therapy
• Mark Corn, D.D.S.
• Cornerstone Counseling
• Kevyn Corona

• Foot Surgery Podiatrist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Foot Surgery Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.