NPIMap

Organization Active NPI

Cooper Family Medical PLLC

  • Family Medicine Physician
  • Bradenton, FL
National Provider Identifier
1871513192
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COOPER FAMILY MEDICAL PLLC
Practice address
5123 4TH Avenue Cir E
Bradenton, FL 34208-5620
Phone
(941) 744-5510
Fax
(941) 744-5166
NPI assigned
Jul 20, 2006
Last updated
Jul 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Dr. Catherine Cooper, D.O.NPI 1558343244
Title
Physician
Phone
(941) 744-5510

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

5123 4TH Avenue Cir E
Bradenton, FL 34208-5620

Mailing address

5123 4TH Avenue Cir E
Bradenton, FL 34208-5620
Phone (941) 744-5510

Other practice location 1

11565 US Highway 301 N
Parrish, FL 34219-8497
Phone (941) 744-5510

Other identifiers 1

IdentifierTypeStateIssuer
74797OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040811000883 FL Part B Supplier - Clinic/Group Practice 9931171782 Receives reassigned benefits from 21 practitioners
Practice locations: Bradenton, FL; Parrish, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1033699Cooper Family Medical PLLC5123 4TH Ave Cir E, Bradenton, FL 34208Certificate of waiverJul 30, 2027
10D2297872Cooper Family Medical, PLLC11565 US Hwy 301 N, Parrish, FL 34219Certificate of waiverJan 23, 2028

National Provider Directory

National Provider Directory

Locations

5101 4th Avenue Cir E
Ste 200
Bradenton, FL 34208
Phone (941) 744-5510

5123 4th Avenue Cir E
Bradenton, FL 34208
Phone (941) 744-5510

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26999/brand/2/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1871513192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5123 4TH AVENUE CIR E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085620",
            "telephone_number": "941-744-5510",
            "fax_number": "941-744-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5123 4TH AVENUE CIR E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085620",
            "telephone_number": "941-744-5510",
            "fax_number": "941-744-5166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11565 US Highway 301 N",
            "address_purpose": "LOCATION",
            "city": "Parrish",
            "state": "FL",
            "postal_code": "342198497",
            "country_code": "US",
            "telephone_number": "941-744-5510",
            "fax_number": "941-744-5516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COOPER FAMILY MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "941-744-5510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "74797",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.