Active NPI
Courtney Cooper
- Mastectomy Fitter
- Winston Salem, NC
National Provider Identifier
1972235752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mastectomy Fitter
- License
- C54085
- Practice address
- 2200 Silas Creek Pkwy
Winston Salem, NC 27103-5000 - Phone
- (336) 760-4333
- NPI assigned
- Jun 29, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | C54085 | NC | |
| Mastectomy Fitter | 224900000X | C54085 | NC | Primary |
Addresses
Primary practice location
2200 Silas Creek Pkwy
Winston Salem, NC 27103-5000
Mailing address
2200 Silas Creek Pkwy
Winston Salem, NC 27103-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C54085 | NC | MD | Mastectomy Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1972235752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 SILAS CREEK PKWY",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271035000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 SILAS CREEK PKWY",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271035000",
"telephone_number": "336-760-4333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-29",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": "NC",
"license": "C54085",
"primary": false
},
{
"code": "224900000X",
"taxonomy_group": "",
"desc": "Mastectomy Fitter",
"state": "NC",
"license": "C54085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.