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COOPER R GUNDRY MD NPI 1659348431


NPI Information

NPI: 1659348431
Provider Name: COOPER R GUNDRY, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
5775 WAYZATA BOULEVARD
SUITE 190
ST LOUIS PARK, MN
ZIP 55416
Phone: (952) 541-1840
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Cooper R Gundry, MD is a diagnostic radiology radiology in St Louis Park, MN with 41 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Cooper R Gundry, MD NPI is 1659348431. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1983

The provider's business location address is:

5775 WAYZATA BOULEVARD
SUITE 190
ST LOUIS PARK, MN
ZIP 55416
Phone: (952) 541-1840
Fax: (952) 513-6880

The NPI 1659348431 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/1/2006 and was last updated on 2/17/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic Radiology33771MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1E24136MEDICARE UPIN
2300000443MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA
3280202500MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.