Individual provider Active NPI

Paul Brandon Cooper, APRN

  • Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1891853354
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
100353 Issued in OK
Practice address
4505 Memorial Cir
Oklahoma City, OK 73142
Phone
(405) 749-7099
Fax
(405) 755-9237
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 100353 OK
Nurse Practitioner 363L00000X 100353 OK Primary

Addresses

Primary practice location

4505 Memorial Cir
Oklahoma City, OK 73142

Mailing address

4505 Memorial Cir
Oklahoma City, OK 73142-5004
Phone (405) 749-7099

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20150818003917 OK Practitioner - Nurse Practitioner 7719070614 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

1919 E Memorial Rd
Oklahoma City, OK 73131-1253
Phone (405) 341-7009

4300 McAuley Blvd
Oklahoma City, OK 73120-8302
Phone (405) 936-5455

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3792OKMDMental Health Counselor
100353OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince May 9, 2016 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince May 9, 2016 Accepting new patients
Mercy Hospital Logan County Inc Current Accepting new patients
Emergency Services of Oklahoma PC Nurse Practitioner CurrentSince Jul 15, 2015 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince May 9, 2016 Accepting new patients
Mercy Oklahoma Ambulatory Services LLC CurrentSince Oct 31, 2022 Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

2801 E Memorial Rd
Ste 140
Edmond, OK 73013
Phone (405) 425-6100

1380 W Covell Rd
Ste 132
Edmond, OK 73003
Phone (405) 279-9637

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

1121 NW 63rd St
Ste 5001
Nichols Hills, OK 73116
Phone (405) 652-0632

8325 NW Expressway
Oklahoma City, OK 73162
Phone (405) 728-8000

4345 W Memorial Rd
Ste 110
Oklahoma City, OK 73134
Phone (405) 749-7099

4505 Memorial Cir
Oklahoma City, OK 73142
Phone (405) 749-7099

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

Interoperability endpoints

  • Direct secure messaging: pcooper750405@directc.mercy.net

Organizations & group practices 8

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 1

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1891853354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 MEMORIAL CIR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731425004",
            "telephone_number": "405-749-7099",
            "fax_number": "405-755-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 MEMORIAL CIR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73142",
            "telephone_number": "405-749-7099",
            "fax_number": "405-755-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "PAUL",
        "middle_name": "BRANDON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "100353",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "100353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.