DR. KELLIE COOPER LP, HSPP
NPI 1316437205
Psychologist - Clinical in Fort Wayne, IN
About Dr. Kellie Cooper Lp, Hspp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KELLIE COOPER LP, HSPP (NPI 1316437205) is an individual clinical provider in Fort Wayne, Indiana, licensed in Michigan (6301016322) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Kellie Cooper Lp, Hspp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kellie Cooper reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fort Wayne, IN 46805
- Reassigned Medicare billing, Indiana enrollment
- 10 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT WAYNE, IN 46805
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kellie Cooper's NPI number?
The NPI number for Kellie Cooper is 1316437205. It was assigned to this individual provider in the NPPES registry on May 16, 2018. The provider is also known as Kellie Cooper-Secrest.
Where is Kellie Cooper located?
Kellie Cooper practices at 3010 E State Blvd, Fort Wayne, IN 46805. The listed phone number is (260) 471-2300.
What is Kellie Cooper's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Kellie Cooper enrolled in Medicare?
Yes. Kellie Cooper is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kellie Cooper's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kellie Cooper reassigns Medicare benefits to Center For Neurobehavioral Services Inc (Fort Wayne, IN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kellie Cooper's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kellie Cooper accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Kellie Cooper as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kellie Cooper was last updated on August 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Kellie Cooper, LP, HSPP · NPI 1316437205
Clinical provider in Fort Wayne, Indiana. Individual provider, active in the CMS NPPES registry since May 16, 2018.
## Identity
- **NPI:** 1316437205 (Entity type: Individual)
- **Enumerated:** May 16, 2018
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** 6301016322 (Michigan)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3010 E STATE BLVD, Fort Wayne, IN 46805-4700
- **Phone:** (260) 471-2300
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Center For Neurobehavioral Services Inc (NPI 1548275258, Fort Wayne, IN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** August 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1316437205) · Data from the CMS NPPES public registry.