MEDICARE: DR. JEFFREY SCOTT COOPER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0005X	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	20107	NE
2	207P00000X	Emergency Medicine Physician	20107	NE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00212587	OTHER	OH	MEDICARE RR
3	P00273469	OTHER	OH	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000360688	OTHER	OH	ANTHEM BCBS
5	000000377192	OTHER	OH	ANTHEM BCBS

General Provider Information

NPI Number	:	1053316927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY SCOTT COOPER MD

Provider Business Mailing Address
First Line	:	988102 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-8102
Country	:	US
Telephone Number	:	402-559-6637
Fax Number	:	402-559-8333

Provider Business Practice Location Address
First Line	:	987400 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198
Country	:	US
Telephone Number	:	402-559-6637
Fax Number	:	402-559-8333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	06/25/2018

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Directions to “ DR. JEFFREY SCOTT COOPER MD” Practice Location

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