Individual provider Active NPI

Kelly Ann Cooper, NP

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1316468820
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3011536 Issued in KY
Practice address
401 E Chestnut St Unit 310
Louisville, KY 40202-5703
Phone
(502) 588-4710
Fax
(502) 588-4771
NPI assigned
Jul 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 3011536 KY Primary

Addresses

Primary practice location

401 E Chestnut St Unit 310
Louisville, KY 40202-5703

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0325

Other practice location 1

220 Abraham Flexner Way # 300
Louisville, KY 40202-3826
Phone (502) 540-1420

Other identifiers 1

IdentifierTypeStateIssuer
300006974MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20171006002023 KY Practitioner - Nurse Practitioner 1355616921 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3011536KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Aug 15, 2017 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Aug 15, 2017 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

401 E Chestnut St
Unit 310
Louisville, KY 40202
Phone (502) 584-8563

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

220 Abraham Flexner Way
#300
Louisville, KY 40202
Phone (502) 540-1420

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1316468820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0325",
            "fax_number": "502-588-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST UNIT 310",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025703",
            "telephone_number": "502-588-4710",
            "fax_number": "502-588-4771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Abraham Flexner Way # 300",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023826",
            "country_code": "US",
            "telephone_number": "502-540-1420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3011536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300006974",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.