DR. ROBERT WAYNE COOPER M.D.
NPI 1194729525
Family Medicine in Williamsburg, KY

NPI Status: Active since June 13, 2005

Contact Information

475 N HIGHWAY 25 W # WN
SUITE 100
WILLIAMSBURG, KY
ZIP 40769
Phone: (606) 549-2933
Fax: (606) 549-3036

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  • Individual
  • Male
  • Family Medicine
  • PECOS Enrolled

About ROBERT COOPER

This page provides the complete NPI Profile along with additional information for Robert Cooper, a primary care provider established in Williamsburg, Kentucky with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1194729525 assigned on June 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 18598 (KY). The provider is registered as an individual and his NPI record was last updated 10 years ago.

NPI
1194729525
Provider Name
DR. ROBERT WAYNE COOPER M.D.
Gender
Male
Entity Type
Individual
Location Address
475 N HIGHWAY 25 W # WN SUITE 100 WILLIAMSBURG, KY 40769
Location Phone
(606) 549-2933
Location Fax
(606) 549-3036
Mailing Address
PO BOX 247 JELLICO, TN 37762
Mailing Phone
(606) 549-2933
Mailing Fax
(606) 549-3036
Is Sole Proprietor?
No
Enumeration Date
06-13-2005
Last Update Date
07-26-2016
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A primary care provider (PCP) like Robert Cooper sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
18598
License State
KY
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

53545 (TN)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
115556OTHER (01)MOHEALTHLINK
7100398340MEDICAID (05)KY 
135570021OTHER (01)MOMEDICARE PTAN
A11614MEDICARE UPIN (02)MO 
Q020836MEDICAID (05)TN 
P00792573OTHER (01)MORAIL ROAD MEDICARE
201533510MEDICAID (05)MO 
3518OTHER (01)MOBLUE CROSS/BLUE SHIELD
1030812011MEDICARE PIN (08)TN 
KI175440MEDICARE PIN (08)KY 
000015278MEDICARE PIN (08)MO 

Medicare Participation & PECOS Enrollment Status

Robert Cooper is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    8 DME suppliers used 58 Medicare Claims 111 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Irrigation syringe, bulb or piston, each (HCPCS:A4322)

    1 DME suppliers used 92 Medicare Claims 639 Services Paid

  • DME-Other DME (DE001N)

    Full face mask used with positive airway pressure device, each (HCPCS:A7030)

    4 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    6 DME suppliers used 18 Medicare Claims 67 Services Paid

  • DME-Hospital Beds (DB000N)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

    2 DME suppliers used 23 Medicare Claims 23 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    2 DME suppliers used 36 Medicare Claims 36 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    6 DME suppliers used 101 Medicare Claims 101 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    4 DME suppliers used 19 Medicare Claims 19 Services Paid

  • DME-Wheelchairs (DD000N)

    Lightweight wheelchair (HCPCS:K0003)

    1 DME suppliers used 36 Medicare Claims 36 Services Paid

  • DME-Other DME (DE017N)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    3 DME suppliers used 19 Medicare Claims 20 Services Paid

  • DME-Other DME (DE000N)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    6 DME suppliers used 36 Medicare Claims 36 Services Paid

Unknown

  • Other-Enteral and Parenteral (OB006N)

    Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4035)

    1 DME suppliers used 82 Medicare Claims 569 Services Paid

  • Other-Enteral and Parenteral (OB006N)

    Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4152)

    2 DME suppliers used 31 Medicare Claims 5650 Services Paid

  • Other-Enteral and Parenteral (OB006N)

    Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4153)

    1 DME suppliers used 41 Medicare Claims 6048 Services Paid

  • Other-Enteral and Parenteral (OB006N)

    Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4154)

    1 DME suppliers used 23 Medicare Claims 3514 Services Paid

Drugs Administered Through DME

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

    6 DME suppliers used 27 Medicare Claims 2640 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 40769 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.24
  • Minimum New Patient Price $52.76
  • Maximum New Patient Price $162.27
  • Average New Patient Copayment $20.56
  • Minimum New Patient Copayment $13.19
  • Maximum New Patient Copayment $40.56

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $93.94
  • Minimum Established Patient Price $16.53
  • Maximum Established Patient Price $131.99
  • Average Established Patient Copayment $23.48
  • Minimum Established Patient Copayment $4.13
  • Maximum Established Patient Copayment $32.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1194729525, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
4
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
5
Unchanged
Pos 9
2
Doubled → 4
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 7 → 14 → 5 9 → 18 → 9 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 8 + 4 + 1 + 4 + 2 + 1 + 8 + 5 + 4 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1194729525.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194729525, enumerated as an "individual" on June 13, 2005.

The provider is located at 475 N HIGHWAY 25 W # WN SUITE 100 WILLIAMSBURG, KY 40769 and the phone number is (606) 549-2933.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.