Active NPI
Kenneth David Cooper, DC
- Chiropractor
- Fullerton, CA
National Provider Identifier
1912114174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 21278
- Practice address
- 680 Langsdorf Dr
# 101
Fullerton, CA 92831-3702 - Phone
- (714) 525-8700
- Fax
- (714) 525-0755
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 21278 | CA | Primary |
Addresses
Primary practice location
680 Langsdorf Dr
# 101
Fullerton, CA 92831-3702
Mailing address
15520 Rockfield Blvd
Ste A200
Irvine, CA 92618-6705
Phone (714) 525-8700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
680 Langsdorf Dr
Suite 101
Fullerton, CA 92831-3702
Phone (714) 525-8700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21278 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Ken Cooper's Cooperstown Chiropractic, Inc. | Chiropractor | Current | Accepting new patients |
| Gregory J Valentine a C P C | Chiropractor | Past | Accepting new patients |
Locations
680 Langsdorf Dr
Ste 101
Fullerton, CA 92831
Phone (714) 525-8700
15520 Rockfield Blvd
Ste A200
Irvine, CA 92618
Organizations & group practices 2
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.
-
- Chiropractor
- Fullerton, CA
- NPI 1912449323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476835200000",
"number": "1912114174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15520 ROCKFIELD BLVD",
"address_2": "STE A200",
"city": "IRVINE",
"state": "CA",
"postal_code": "926186705",
"telephone_number": "714-525-8700",
"fax_number": "714-525-0755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 LANGSDORF DR",
"address_2": "# 101",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928313702",
"telephone_number": "714-525-8700",
"fax_number": "714-525-0755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "KENNETH",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2016-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "21278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.