Individual provider Active NPI

Tina Coop

  • Family Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1053144352
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R243396 Issued in MD
Practice address
74 Thomas Johnson Dr
Frederick, MD 21702-4501
Phone
(301) 694-9033
NPI assigned
Aug 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 R243396 MD Primary

Addresses

Primary practice location

74 Thomas Johnson Dr
Frederick, MD 21702-4501

Mailing address

1570 Wheyfield Dr
Frederick, MD 21701-2511
Phone (240) 586-1903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241206001583 MD Practitioner - Nurse Practitioner 5092241562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sherman Kahan, M.D., P.a.Group PAC ID 7012927759, 15 clinicians

Practice addresses (Care Compare)

74 Thomas Johnson Dr
Frederick, MD 21702-4501
Phone (301) 694-9033

Hospital & facility affiliations

  • Frederick Health Hospital Hospital, Frederick, MD, CCN 210005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R243396MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sherman Kahan, MD, PA CurrentSince Dec 4, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

74 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 694-3200

900 Toll House Ave
Frederick, MD 21701
Phone (301) 662-0077

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1053144352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 WHEYFIELD DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217012511",
            "telephone_number": "240-586-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024501",
            "telephone_number": "301-694-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOP",
        "first_name": "TINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R243396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.