NPIMap

Organization Active NPI

Cooper Pediatric Specialist

  • Pediatric Allergy/Immunology Physician
  • Voorhees, NJ
National Provider Identifier
1972634129
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
Legal business name
COOPER PEDIATRIC SPECIALIST
Practice address
6400 Main St
Voorhees, NJ 08043-4606
Phone
(856) 751-9339
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert McMullen
Title
Evp Manged Care
Phone
(856) 342-7263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0201X Primary

Addresses

Primary practice location

6400 Main St
Voorhees, NJ 08043-4606

Mailing address

3 Cooper PLZ
Suite 502
Camden, NJ 08103-1438
Phone (856) 968-7433

Other identifiers 2

IdentifierTypeStateIssuer
9024603MedicaidNJ
2123898000OtherNJAMERIHEALTH GRP #

National Provider Directory

National Provider Directory
Tax ID family
Cooper Pediatric Specialists15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972634129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 502",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-968-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 MAIN ST",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434606",
            "telephone_number": "856-751-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER PEDIATRIC SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EVP MANGED CARE",
        "authorized_official_telephone_number": "856-342-7263"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9024603",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH GRP #",
            "identifier": "2123898000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.