Ivan N Cooper, D.P.M., P.C.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

DPM132 Issued in TN

Practice address

1932 Alcoa Hwy
Suite C-480
Knoxville, TN 37920-1527

Phone

(865) 632-5700

Fax

(865) 632-5778

NPI assigned

Oct 13, 2006

Last updated

Dec 31, 2010By 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 2

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4694/brand/1/csg/1/fhir/r4

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.

• Ivan N Cooper, DPM, PC

  dba Knoxville Footcare

  • Podiatrist
  • Knoxville, TN
  • NPI 1255413316
  Medicare reassignment NPD Authorized official
• Knoxville Hma Physician Management, LLC

  • Pulmonary Disease Physician
  • Knoxville, TN
  • NPI 1629356969
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293753600000",
    "number": "1952491748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1932 ALCOA HWY",
            "address_2": "SUITE C-480",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201527",
            "telephone_number": "865-632-5700",
            "fax_number": "865-632-5778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 ALCOA HWY",
            "address_2": "SUITE C-480",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201527",
            "telephone_number": "865-632-5700",
            "fax_number": "865-632-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "IVAN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.P.M., P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2010-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "DPM132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "2008103",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3350481",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris Cooper
• Crystal Cooper, B.A.
• David Wayne Cooper, MD
• Elizabeth Cherie Cooper, DVM
• Gary L Cooper, MD
• John F Cooper, MD
• John H Cooper, M.D.
• Jon Cooper, P.T.
• Kaylan Nicole Cooper, LMSW
• Kimberly S Cooper

• Podiatrist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Podiatrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2010; 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.