Carroll Donell Cooper, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

63309 Issued in GA

Practice address

251 Medical Way
Suite B
Riverdale, GA 30274-2522

Phone

(678) 974-0158

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Oaktree Medical Centre, PC

  • Clinic/Center
  • Easley, SC
  • NPI 1154308617
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1861570012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 HOWELL MILL RD NW",
            "address_2": "SUITE 310",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303272135",
            "telephone_number": "678-974-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 MEDICAL WAY",
            "address_2": "SUITE B",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742522",
            "telephone_number": "678-974-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CARROLL",
        "middle_name": "DONELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "63309",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "63309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Comfort Healthcare System, LLC
• Compassionate Care
• Compassionate Helpers Homecare Services LLC
• Consecrated Care Inc
• Camille Pleshette Cook, FNP-C
• Rhonda Denise Cooper, RN
• Jaleesa Copeland
• Eureka Faye Peek Corbin, RBT
• Cornerstone Health Services, Inc-
• Mark Edward Couch, FNP-C

• Interventional Pain Medicine Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.