Koren F Cooper, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110005485 Issued in VA

Practice address

16011 Kairos Rd
Suite 300
South Chesterfield, VA 23834

Phone

(804) 520-5223

Fax

(804) 520-5746

NPI assigned

Oct 16, 2012

Last updated

Sep 6, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Koren V Fleming Former name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272
  Medicare reassignment
• Caromont Medical Group Inc

  dba CaroMont Gastroenterology and Hepatology

  • Gastroenterology Physician
  • Gastonia, NC
  • NPI 1407036056
  NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1881947893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WADSWORTH DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232364521",
            "telephone_number": "804-330-4901",
            "fax_number": "804-330-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16011 KAIROS RD",
            "address_2": "SUITE 300",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "23834",
            "telephone_number": "804-520-5223",
            "fax_number": "804-520-5746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 Wadsworth Dr",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232364510",
            "country_code": "US",
            "telephone_number": "804-330-4021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KOREN",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03871",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110005485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KOREN",
            "last_name": "FLEMING",
            "middle_name": "V",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chafhllc
• Linette Cleveland, GRAPHICS DESIGNER
• Colonial Heights Pediatrics
• Commonwealth Foot & Ankle Specialists LLC (Commonwealth Foot & Ankle Specialists)
• Consolidated Care Behavioral Health
• Cooper's Meats LLC
• Counsel Connect, LLC
• Danielle N Crane, LPC
• Kylar Ann Dabney
• Destined Care Mental Health Services LLC

• Physician Assistant in South Chesterfield, VA
• Providers in South Chesterfield, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.