Individual provider Active NPI

Elizabeth Leigh Cooper

  • Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1407418098
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN231470 Issued in GA
Practice address
3850 Windermere Pkwy Ste 105
Cumming, GA 30041-7033
Phone
(678) 455-2800
Fax
(770) 888-9998
NPI assigned
Jul 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN231470 GA
Nurse Practitioner 363L00000X RN231470 GA Primary

Addresses

Primary practice location

3850 Windermere Pkwy Ste 105
Cumming, GA 30041-7033

Mailing address

270 Greenmont Cir
Alpharetta, GA 30009-3497
Phone (770) 355-2875

Other practice location 1

2151 W Spring St
Monroe, GA 30655-3202
Phone (770) 267-8461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20191107002225 GA Practitioner - Nurse Practitioner 9739511098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

2151 W Spring St
Monroe, GA 30655-3202
Phone (770) 267-8461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC Nurse Practitioner CurrentSince Oct 1, 2019 Accepting new patients

Locations

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1407418098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 GREENMONT CIR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300093497",
            "telephone_number": "770-355-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 WINDERMERE PKWY STE 105",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417033",
            "telephone_number": "678-455-2800",
            "fax_number": "770-888-9998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2151 W Spring St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "GA",
            "postal_code": "306553202",
            "country_code": "US",
            "telephone_number": "770-267-8461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ELIZABETH",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "GA",
            "license": "RN231470",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN231470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.