Individual provider Active NPI

Grant Wayne Cooper, MSCN FNP

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1205825148
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP0851 Issued in AZ
Practice address
6336 W Honeysuckle Dr
Glendale, AZ 85310-1824
Phone
(623) 204-4914
Fax
(623) 322-1809
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 AP0851 AZ Primary

Addresses

Primary practice location

6336 W Honeysuckle Dr
Glendale, AZ 85310-1824

Mailing address

6336 W Honeysuckle Dr
Glendale, AZ 85310-1824
Phone (623) 204-4914

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP0851AZMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1205825148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6336 W HONEYSUCKLE DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853101824",
            "telephone_number": "623-204-4914",
            "fax_number": "623-322-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6336 W HONEYSUCKLE DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853101824",
            "telephone_number": "623-204-4914",
            "fax_number": "623-322-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "GRANT",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "MSCN FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP0851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.