JAC A. COOPER, SR. M.D. – NPI #1760487425
Surgery

A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

JAC COOPER, SR. is a surgeon located in VALPARAISO, IN. NPPES has assigned the NPI number 1760487425 to JAC COOPER, SR. on June 17, 2005. It is a Type-1 NPI, indicating this NPI number is associated with an individual. According to the NPI data, there are 2 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 2086S0102X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Surgical Critical Care

The NPI profile was previously updated about 6 years ago on Sep 14, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JAC COOPER, SR. below.

NPI Profile for
JAC A. COOPER, SR.

NPI Number
1760487425
Enumeration Date

(about 21 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
JAC A. COOPER, SR.
Credentials
M.D.
Primary location
85 E US HIGHWAY 6 STE 240
VALPARAISO, IN 46383
Phone: (219) 983-6240 Fax: (219) 983-6040
2 Other location(s):
3630 Willowcreek Rd
Ste 3
Portage, IN 46368-5075
Phone: (219) 759-4577
Fax: (219) 759-3564
2000 Roosevelt Rd Ste 104
Valparaiso, IN 46383-2801
Phone: (219) 983-6240
Fax: (219) 983-6040
Mailing address
2022 KELLE DR
CHESTERTON, IN 46304-8708
Phone: (219) 364-3616 Fax: (219) 364-3610
Sole Proprietor
No
Updated
Certification Date
Sep 14, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for JAC COOPER, SR.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERANTHEMIN000000082449
MEDICAIDIN100207020
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0102X
- Surgery / Surgical Critical Care (Primary)
IN 01035869A

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
AMR DIRECT ADDRESS
Content Type
Affiliation
N
Endpoint Location
85 E US HIGHWAY 6 STE 240,
VALPARAISO, IN 77025-1669