NPIMap

Organization Active NPI

BC Chiropractic Clinic

Doing business as Cooper Chiropractic

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1922271352
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034562 Issued in WA
Legal business name
BC CHIROPRACTIC CLINIC
Doing business as
Cooper Chiropractic
Practice address
4001 Main St
Suite 300
Vancouver, WA 98663-1887
Phone
(360) 693-3030
Fax
(360) 828-1305
NPI assigned
Apr 7, 2008
Last updated
Feb 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Authorized official

Name
Dr. Matthew Goodall Cooper, BS, DCNPI 1154424331
Title
Ceo
Phone
(360) 693-3030

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
Chiropractor 111N00000X CH00034562 WA Primary

Addresses

Primary practice location

4001 Main St
Suite 300
Vancouver, WA 98663-1887

Mailing address

4001 Main St
Suite 300
Vancouver, WA 98663-1887
Phone (360) 693-3030

Other names 1

  • Cooper Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150724011328 WA Part B Supplier - Clinic/Group Practice 6103139738 Receives reassigned benefits from 6 practitioners
Practice locations: Vancouver, WA

National Provider Directory

National Provider Directory

Locations

4001 Main St
Ste 200
Vancouver, WA 98663
Phone (360) 693-3030

4001 Main St
Ste 300
Vancouver, WA 98663
Phone (360) 693-3030

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1922271352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 MAIN ST",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986631887",
            "telephone_number": "360-693-3030",
            "fax_number": "360-828-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 MAIN ST",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986631887",
            "telephone_number": "360-693-3030",
            "fax_number": "360-828-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BC CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "GOODALL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-693-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BS, DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cooper Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.