Active NPI
Amanda Cooper
- Pediatric Nurse Practitioner
- Gurley, AL
National Provider Identifier
1235901745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 1-195825
- Practice address
- 14 Taylors Brook Way SE
Gurley, AL 35748-8050 - Phone
- (203) 564-0666
- NPI assigned
- Oct 27, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 1-195825 | AL | Primary |
Addresses
Primary practice location
14 Taylors Brook Way SE
Gurley, AL 35748-8050
Mailing address
14 Taylors Brook Way SE
Gurley, AL 35748-8050
Phone (203) 564-0666
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 |
|---|---|---|---|
| 1-195825 | AL | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698364800000",
"number": "1235901745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 TAYLORS BROOK WAY SE",
"city": "GURLEY",
"state": "AL",
"postal_code": "357488050",
"telephone_number": "203-564-0666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 TAYLORS BROOK WAY SE",
"city": "GURLEY",
"state": "AL",
"postal_code": "357488050",
"telephone_number": "203-564-0666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-27",
"last_updated": "2023-10-27",
"certification_date": "2023-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "AL",
"license": "1-195825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gurley, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.