Individual provider Active NPI

Michelle Ann Cooley, ARNP

  • Family Nurse Practitioner
  • Lake Mary, FL
National Provider Identifier
1316120504
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9190202 Issued in FL
Practice address
910 Williston Park PT Ste 2050
Lake Mary, FL 32746-2128
Phone
(407) 829-8960
Fax
(407) 829-8978
NPI assigned
Dec 11, 2007
Last updated
Aug 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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 ARNP9190202 FL Primary

Addresses

Primary practice location

910 Williston Park PT Ste 2050
Lake Mary, FL 32746-2128

Mailing address

910 Williston Park PT Ste 2050
Lake Mary, FL 32746-2128
Phone (407) 829-8960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080212000256 FL Practitioner - Nurse Practitioner 4880777010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Heathrow Internal Medicine LLCGroup PAC ID 5294801536, 13 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

4106 W Lake Mary Blvd
Suite 100
Lake Mary, FL 32746-3344
Phone (407) 333-2273

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heathrow Internal Medicine LLC CurrentSince Jul 18, 2016 Accepting new patients
Lake Mary Family Physicians P.a. PastSince Aug 14, 2022 Accepting new patients

Locations

4106 W Lake Mary Blvd
Ste 100
Lake Mary, FL 32746
Phone (407) 333-2273

910 Williston Park Pt
Ste 2050
Lake Mary, FL 32746
Phone (407) 829-8960

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: michelle.cooley@hca4.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1316120504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 WILLISTON PARK PT STE 2050",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462128",
            "telephone_number": "407-829-8960",
            "fax_number": "407-829-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WILLISTON PARK PT STE 2050",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462128",
            "telephone_number": "407-829-8960",
            "fax_number": "407-829-8978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9190202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.