Individual provider Active NPI

Holly Sue Cooper, MD

  • Emergency Medicine Physician
  • Richland, WA
National Provider Identifier
1821039447
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00042083 Issued in WA
Practice address
888 Swift Blvd
Richland, WA 99352-3514
Phone
(509) 946-4611
Fax
(509) 942-2757
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD00042083 WA Primary

Addresses

Primary practice location

888 Swift Blvd
Richland, WA 99352-3514

Mailing address

505 S 336TH St
Suite 600
Federal Way, WA 98003-6328
Phone (253) 838-6180

Other identifiers 3

IdentifierTypeStateIssuer
3075COOtherWABSWA
8352189MedicaidWA
0202682OtherWALIWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050419001319 WA Practitioner - Emergency Medicine 9830137991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Emergency Physicians LLCGroup PAC ID 3476462334, 267 clinicians

Practice addresses (Care Compare)

401 W Poplar St
Walla Walla, WA 99362-2846
Phone (509) 897-2500

888 Swift Blvd
Richland, WA 99352-3514
Phone (509) 946-4611

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00042083WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Nov 1, 2005 Accepting new patients
Providence Health & Services - Washington CurrentSince Apr 7, 2025 Accepting new patients
Providence Health & Services - Washington CurrentSince Apr 7, 2025 Accepting new patients
Northwest Physician Associates, Apc Emergency Medicine Past Accepting new patients

Locations

3290 W 19th Ave
Kennewick, WA 99337
Phone (509) 942-2485

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

401 W Poplar St
Walla Walla, WA 99362
Phone (509) 522-5731

380 Chase Ave
Walla Walla, WA 99362
Phone (509) 526-3333

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1821039447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST",
            "address_2": "SUITE 600",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036328",
            "telephone_number": "253-838-6180",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 SWIFT BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523514",
            "telephone_number": "509-946-4611",
            "fax_number": "509-942-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "HOLLY",
        "middle_name": "SUE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00042083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "3075CO",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8352189",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0202682",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.