Active NPI
Hertayzia Eshay Cooper
- Homemaker
- Gainesville, FL
National Provider Identifier
1003571175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- License
- 87-3080428
- Practice address
- 3019 NE 20TH Way
Gainesville, FL 32609-3395 - Phone
- (352) 283-3287
- NPI assigned
- Nov 3, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 87-3080428 | FL | |
| Homemaker | 376J00000X | 87-3080428 | FL | Primary |
Addresses
Primary practice location
3019 NE 20TH Way
Gainesville, FL 32609-3395
Mailing address
1415 SE 42ND PL
Gainesville, FL 32641-9268
Phone (352) 283-3287
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 87-3080428 | Other | FL | COMPANIONSHIP & HOMEMAKER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87-3080428 | FL | MD | Homemaker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635897600000",
"number": "1003571175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 SE 42ND PL",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326419268",
"telephone_number": "352-283-3287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3019 NE 20TH WAY",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326093395",
"telephone_number": "352-283-3287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "HERTAYZIA",
"middle_name": "ESHAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-03",
"last_updated": "2021-11-03",
"certification_date": "2021-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "FL",
"license": "87-3080428",
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "FL",
"license": "87-3080428",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPANIONSHIP & HOMEMAKER",
"identifier": "87-3080428",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.