Individual provider Active NPI

Leslie Jeanette Cooper Sullivan, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1023828159
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RNP318160 Issued in AZ
Practice address
426 N 44TH St Ste 405
Phoenix, AZ 85008-6612
Phone
(602) 476-2047
NPI assigned
Jan 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RNP318160 AZ Primary

Addresses

Primary practice location

426 N 44TH St Ste 405
Phoenix, AZ 85008-6612

Mailing address

10646 E Carol Ave
Mesa, AZ 85208-7434
Phone (480) 450-5999

Other names 1

  • Leslie Cooper Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RNP318160AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Hospice LLC CurrentSince Jan 12, 2025 Accepting new patients
Palliative Care Alliance, LLC CurrentSince Mar 1, 2025 Accepting new patients
Hospice of the Southwest - West Valley, LLC PastSince Sep 4, 2018 Accepting new patients

Locations

426 N 44th St
Ste 405
Phoenix, AZ 85008
Phone (602) 476-2047

426 N 44th St
Ste 450
Phoenix, AZ 85008
Phone (602) 269-6011

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1023828159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10646 E CAROL AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852087434",
            "telephone_number": "480-450-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 N 44TH ST STE 405",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086612",
            "telephone_number": "602-476-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER SULLIVAN",
        "first_name": "LESLIE",
        "middle_name": "JEANETTE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RNP318160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "COOPER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.