Individual provider Active NPI

Sorelle Nicole Jones Cooper, FNP

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1205146362
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R183786 Issued in MD
Practice address
4130 Hunt PL NE
Washington, DC 20019-3565
Phone
(202) 388-8160
Fax
(202) 388-8746
NPI assigned
Oct 7, 2010
Last updated
Sep 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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 R183786 MD Primary

Addresses

Primary practice location

4130 Hunt PL NE
Washington, DC 20019-3565

Mailing address

4130 Hunt PL NE
Washington, DC 20019-3565
Phone (202) 388-8160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20110718000180 DC Practitioner - Nurse Practitioner 3971771031 Reassigns benefits to 1 organization
Practice locations: Hyattsville, MD

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R183786MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Health Care, Inc. CurrentSince May 16, 2011 Accepting new patients
3Rdroom Enterprises CurrentSince Mar 9, 2021 Accepting new patients
Unity Health Care Inc. CurrentSince May 16, 2011 Accepting new patients

Locations

1310 Southern Ave SE
Washington, DC 20032
Phone (202) 574-6000

4130 Hunt Pl NE
Washington, DC 20019
Phone (202) 388-4320

7100 Chesapeake Rd
Ste 101
Hyattsville, MD 20784
Phone (718) 781-0585

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1205146362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 HUNT PL NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193565",
            "telephone_number": "202-388-8160",
            "fax_number": "202-388-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 HUNT PL NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193565",
            "telephone_number": "202-388-8160",
            "fax_number": "202-388-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "SORELLE",
        "middle_name": "NICOLE JONES",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R183786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.