Active NPI
Shadday Cooper
- Community Health Worker
- Taylor, TX
National Provider Identifier
1316827710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 612 Davis St
Taylor, TX 76574-2729 - Phone
- (512) 352-2330
- NPI assigned
- Sep 5, 2025
- Last updated
- Sep 5, 2025
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
612 Davis St
Taylor, TX 76574-2729
Mailing address
2100 Scenic Dr Ste 140
Georgetown, TX 78626-7720
Phone (512) 713-9886
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Impact Counseling Services, Inc. | Current | Accepting new patients |
Locations
2100 Scenic Dr
Ste 140
Georgetown, TX 78626
Phone (512) 713-9886
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Georgetown, TX
- NPI 1396312658
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757030400000",
"number": "1316827710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 SCENIC DR STE 140",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786267720",
"telephone_number": "512-713-9886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 DAVIS ST",
"city": "TAYLOR",
"state": "TX",
"postal_code": "765742729",
"telephone_number": "512-352-2330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "SHADDAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-05",
"last_updated": "2025-09-05",
"certification_date": "2025-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylor, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.