Individual provider Active NPI

Jenna Tantalo-Cooper

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1184388183
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
330009-01 Issued in NY
Practice address
35 Sharon Drive
Rochester, NY 14626
Phone
(585) 738-5140
NPI assigned
Oct 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 330009-01 NY Primary

Addresses

Primary practice location

35 Sharon Drive
Rochester, NY 14626

Mailing address

35 Sharon Dr
Rochester, NY 14626-2014
Phone (585) 738-5140

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
330009-01NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1184388183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 SHARON DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146262014",
            "telephone_number": "585-738-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 SHARON DRIVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14626",
            "telephone_number": "585-738-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANTALO-COOPER",
        "first_name": "JENNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "330009-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.