KEVIN MAYNARD COOPER (FNP-C) – Family Nurse Practitioner, NPI 1396394417

KEVIN MAYNARD COOPER (FNP-C) is a healthcare provider. based in Allegan, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 4704267613 (MI). The NPI Number for KEVIN MAYNARD COOPER (FNP-C) is 1396394417

Main info

Male
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN MAYNARD COOPER (FNP-C)
NPI
1396394417
Phone
(231) 425-6360
Address
2961 122ND AVE
Enumeration Date
11 September 2019
Last Update Date
11 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2696864926
Graduation Year
2019 (7 years ago)
PAC ID
3678906161
Group Practice PAC ID
5092750356
Professional Enrollment ID
I20191216000641
Address ID
MI490101595AL551XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

8,105 NURSE PRACTITIONER in MI

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Provider Addresses for KEVIN MAYNARD COOPER (FNP-C)

  • 2961, 122nd Avenue, Allegan Township, Allegan County, Michigan, 49010, United States

    ALLEGAN, MI 490108508

    Phone: (231) 425-6360

    Type: Mailing

  • Allegan General Hospital, 555, Linn Street, Allegan, Allegan Township, Allegan County, Michigan, 49010, United States

    ALLEGAN, MI 490101524

    Phone: (269) 686-5800

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $41.

Total Amount is formed as General ($41) + Research ($0) + Ownership ($0) = $41.

Last reported payment date: 2024-07-29 • Largest payer in this snapshot: Novo Nordisk Inc ($41).

Total Amount

$41

General + Research + Ownership

Payments

3

Total payment records

General Amount

$41

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-29

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Novo Nordisk Inc$41
View all Open Payments →|Open Payments Risk Radar →

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: 2019-12-16

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
I20191216000641INurse PractitionerMITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49010)

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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: 5092750356View full group profile
NameSpecialtyState
Physician AssistantMI
Nurse PractitionerMI
Family PracticeMI
Physician AssistantMI
-MI
-MI
-MI
Family PracticeMI
Nurse PractitionerMI
Nurse PractitionerMI

Reviews

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Frequently asked questions

What federal number belongs to KEVIN MAYNARD COOPER (FNP-C)?
The federal identifier for KEVIN MAYNARD COOPER (FNP-C) is NPI 1396394417.
Is KEVIN MAYNARD COOPER (FNP-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does KEVIN MAYNARD COOPER (FNP-C) treat or focus on?
Patients typically see KEVIN MAYNARD COOPER (FNP-C) under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is KEVIN MAYNARD COOPER (FNP-C)'s primary listing?
We display Allegan, Michigan because that is what the record indicates for KEVIN MAYNARD COOPER (FNP-C).
How can I contact KEVIN MAYNARD COOPER (FNP-C)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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