Individual provider Active NPI

Courtney Danielle Cooper, PA

  • Physician Assistant
  • Glen Dale, WV
National Provider Identifier
1275279937
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
800 Wheeling Ave
Glen Dale, WV 26038-1660
Phone
(304) 845-3211
NPI assigned
May 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

800 Wheeling Ave
Glen Dale, WV 26038-1660

Mailing address

800 Wheeling Ave
Glen Dale, WV 26038-1697
Phone (304) 845-3211

Other names 1

  • Courtney Danielle Amend Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20220824001215 WV Practitioner - Physician Assistant 2567845522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reynolds Memorial Hospital, IncGroup PAC ID 9830184530, 152 clinicians

Practice addresses (Care Compare)

800 Wheeling Ave
Glen Dale, WV 26038-1660
Phone (304) 843-3307

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2616WVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeling Hospital Inc CurrentSince Apr 22, 2024 Accepting new patients
Reynolds Memorial Hospital, Inc CurrentSince Apr 15, 2024 Accepting new patients
Wheeling Hospital Inc Past Accepting new patients

Locations

800 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 221-4520

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1275279937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381697",
            "telephone_number": "304-845-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381660",
            "telephone_number": "304-845-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "COURTNEY",
        "middle_name": "DANIELLE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-06",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "AMEND",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glen Dale, WV

Sources for this page

Verify at the official NPI Registry.