Individual provider Active NPI

Hertayzia Eshay Cooper

  • Homemaker
  • Gainesville, FL
National Provider Identifier
1003571175
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
License
87-3080428 Issued in FL
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

Updated by the provider on Nov 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
87-3080428OtherFLCOMPANIONSHIP & 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

LicenseStateTypeSpecialty
87-3080428FLMDHomemaker

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.

Verify at the official NPI Registry.