Mary Cooper, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209024241 Issued in IL

Practice address

3301 Broadway St
Quincy, IL 62301-3713

Phone

(217) 277-4090

Fax

(217) 277-6778

NPI assigned

Aug 4, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quincy Physicians and Surgeons Clinic, PLLCGroup PAC ID 0749192375, 231 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcooper510661@direct.novanthealth.org
• Direct secure messaging: mcooper850895@direct.unitypoint.org

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

• Quincy Physicians & Surgeons Clinic, PLLC

  • Clinic/Center
  • Quincy, IL
  • NPI 1548234198
  Medicare reassignment Care Compare group NPD
• Quincy Physicians & Surgeons Clinic, PLLC

  dba Quincy Medical Group Barry Affiliate

  • Rural Health Clinic/Center
  • Barry, IL
  • NPI 1013981547
  NPD
• Quincy Physicians & Surgeons Clinic, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Pittsfield, IL
  • NPI 1871794925
  NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154846707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013713",
            "telephone_number": "217-277-4090",
            "fax_number": "217-277-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013713",
            "telephone_number": "217-277-4090",
            "fax_number": "217-277-6778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Kimel Park Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036983",
            "country_code": "US",
            "telephone_number": "336-768-3212",
            "fax_number": "336-768-9019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MARY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-04",
        "last_updated": "2022-07-21",
        "certification_date": "2021-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "280593",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209024241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MCOOPER510661@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "145 Kimel Park Dr Ste 120",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth T Cook
• Jeffrey R Cook, M.D.
• Jill Cook
• Dinita Cooley, O.D.
• William Elijah Coonrod
• Cornerstone Foundations for Families (Cornerstone Foundation for Families)
• Jace P. Corray, DNAP
• Nicole L Cory, PT
• County of Adams
• Katherine Cowan, BS MHP

• Certified Registered Nurse Anesthetist in Quincy, IL
• Providers in Quincy, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.