Individual provider Active NPI

Shakema Josey Cooper, NP-BC

  • Nurse Practitioner
  • Warner Robins, GA
National Provider Identifier
1346830387
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN204858 Issued in GA
Practice address
92 Tommy Stalnaker Dr
Warner Robins, GA 31088-9179
Phone
(478) 333-2522
NPI assigned
Jan 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN204858 GA Primary

Addresses

Primary practice location

92 Tommy Stalnaker Dr
Warner Robins, GA 31088-9179

Mailing address

92 Tommy Stalnaker Dr
Warner Robins, GA 31088-9179
Phone (478) 333-2522

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

LicenseStateTypeSpecialty
RN204858GAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1611360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1346830387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 TOMMY STALNAKER DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889179",
            "telephone_number": "478-333-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 TOMMY STALNAKER DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889179",
            "telephone_number": "478-333-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "SHAKEMA",
        "middle_name": "JOSEY",
        "credential": "NP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-23",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN204858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.