Clayton E Cooper

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

801 E Main St
Tishomingo, OK 73460-2351

Phone

(580) 371-3776

Fax

(580) 371-2056

NPI assigned

Dec 3, 2012

Last updated

Dec 3, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Pennington Creek Life House

  • Community/Behavioral Health Agency
  • Tishomingo, OK
  • NPI 1164771366
  NPD (past)
• Pennington Creek Lifehouse

  • Community/Behavioral Health Agency
  • Tishomingo, OK
  • NPI 1831464304
  NPD (past)

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1942545991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MICHELLE DR",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749532083",
            "telephone_number": "918-839-0377",
            "fax_number": "918-647-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E MAIN ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734602351",
            "telephone_number": "580-371-3776",
            "fax_number": "580-371-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CLAYTON",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-03",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200226970A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Collins Chiropractic Clinic
• Derek Lance Collins, D.C.
• Vicki Sue Collins, D.C.
• Complete Home Health of Tishomingo LLC
• Kenneth Leslie Cone, DDS
• Jennifer Corbin, RN
• Lisa June Coulter
• Counseling, Inc.
• Kimberly Cripps, RN
• Ladonna Culp, APRN

• Addiction (Substance Use Disorder) Counselor in Tishomingo, OK
• Providers in Tishomingo, OK by specialty
• Addiction (Substance Use Disorder) Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.