SALLY A. COOPER (D.O.) – Family Medicine Physician, NPI 1487646725

SALLY A. COOPER (D.O.) is a healthcare provider. based in Fort walton beach, Florida. specializing in FAMILY PRACTICE, EMERGENCY MEDICINE. They hold the professional credentials D.O.. They hold a License No. OS9434 (FL). The NPI Number for SALLY A. COOPER (D.O.) is 1487646725

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
SALLY A. COOPER (D.O.)
NPI
1487646725
Phone
(850) 833-9240
Address
221 HOSPITAL DR NE
Enumeration Date
22 August 2005
Last Update Date
28 July 2011

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
8508339233
Graduation Year
1999 (27 years ago)
PAC ID
4082649736
Group Practice PAC ID
3072424282
Professional Enrollment ID
I20050930000304
Address ID
FL325485066FO221XXNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

6,722 FAMILY PRACTICE in FL

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Provider Addresses for SALLY A. COOPER (D.O.)

  • Hospital Drive Northeast, Fort Walton Beach, Okaloosa County, Florida, 32548, United States

    FORT WALTON BEACH, FL 325485066

    Phone: (850) 833-9240

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050930000304IFamily PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes5217$0
View full utilization report →

Insurance plans in this area (ZIP 32548)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3072424282View full group profile

Reviews

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Frequently asked questions

Is SALLY A. COOPER (D.O.) listed with a National Provider Identifier?
Yes — SALLY A. COOPER (D.O.) has NPI 1487646725 on file in the registry.
Is SALLY A. COOPER (D.O.) shown as active in public data?
Registry records indicate SALLY A. COOPER (D.O.) maintains an active NPI.
What clinical focus is listed for SALLY A. COOPER (D.O.)?
At a glance, SALLY A. COOPER (D.O.) is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for SALLY A. COOPER (D.O.)?
Travel planning: use Fort Walton Beach, Florida as the reference point for SALLY A. COOPER (D.O.), then confirm.
Can I trust this NPI listing for SALLY A. COOPER (D.O.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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