Active NPI
Shatrisse Markita Cooper
- Social Worker
- Jamaica, NY
National Provider Identifier
1053913087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 109526
- Practice address
- 10710 Guy R Brewer Blvd Unit 9C
Jamaica, NY 11433-2388 - Phone
- (646) 708-3034
- NPI assigned
- Nov 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 109526 | NY | Primary |
Addresses
Primary practice location
10710 Guy R Brewer Blvd Unit 9C
Jamaica, NY 11433-2388
Mailing address
10710 Guy R Brewer Blvd Unit 9C
Jamaica, NY 11433-2388
Phone (646) 708-3034
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 |
|---|---|---|---|
| 109526 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605225600000",
"number": "1053913087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10710 GUY R BREWER BLVD UNIT 9C",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114332388",
"telephone_number": "646-708-3034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10710 GUY R BREWER BLVD UNIT 9C",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114332388",
"telephone_number": "646-708-3034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "SHATRISSE",
"middle_name": "MARKITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-13",
"last_updated": "2020-11-13",
"certification_date": "2020-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "109526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.