Individual provider Active NPI

John Taylor Cooper, O.D.

  • Optometrist
  • Atmore, AL
National Provider Identifier
1821032012
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AL S-651-TA-315 Issued in AL
Practice address
212 S Main St
Atmore, AL 36502-2448
Phone
(251) 368-8558
NPI assigned
Jun 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X AL S-651-TA-315 AL Primary
Optometrist 152W00000X OPC 2443 FL
Optometrist 152W00000X 702 MS
Optometrist 152W00000X 1269 GA

Addresses

Primary practice location

212 S Main St
Atmore, AL 36502-2448

Mailing address

22 Elizabeth PL
Mobile, AL 36606-1918
Phone (251) 391-0375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20051205000291 AL Practitioner - Optometry 5193745271 Practice locations: Atmore, AL; Brewton, AL; Robertsdale, AL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

212 S Main St
Atmore, AL 36502-2448
Phone (251) 368-8558

301 Saint Joseph Ave
Brewton, AL 36426-2025
Phone (251) 867-6891

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AL S-651-TA-315ALMDOptometrist
OPC 2443FLMDOptometrist
1269GAMDOptometrist
702MSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hub City Eyecare Inc Past Accepting new patients
Hub City Eyecare Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821032012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ELIZABETH PL",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366061918",
            "telephone_number": "251-391-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S MAIN ST",
            "city": "ATMORE",
            "state": "AL",
            "postal_code": "365022448",
            "telephone_number": "251-368-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JOHN",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "AL S-651-TA-315",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 2443",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "702",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atmore, AL

Sources for this page

Verify at the official NPI Registry.