Individual provider Active NPI

Melinda Marie Cooper, FNP

  • Family Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1417629403
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AC005797 Issued in MD
Practice address
1741 Dual Hwy
Hagerstown, MD 21740-6624
Phone
(301) 337-7749
NPI assigned
Sep 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024188012 VA
Family Nurse Practitioner 363LF0000X 117249 WV
Family Nurse Practitioner 363LF0000X PA066069 PA
Family Nurse Practitioner 363LF0000X RN2386999 MA
Family Nurse Practitioner 363LF0000X AC005797 MD Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 904864 MS

Addresses

Primary practice location

1741 Dual Hwy
Hagerstown, MD 21740-6624

Mailing address

11217 Karli LN
Biloxi, MS 39532-8026
Phone (228) 257-9289

Other identifiers 1

IdentifierTypeStateIssuer
1417629403MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, WV, MD, VA, PA, MA, DC, GA8 enrollments
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 8

Enrollment IDStateProvider typePAC IDDetails
I20211007000975 MS Practitioner - Nurse Practitioner 7113325036 Reassigns benefits to 1 organization
I20230925000382 WV Practitioner - Nurse Practitioner 7113325036
I20231008000051 MD Practitioner - Nurse Practitioner 7113325036 Reassigns benefits to 2 organizations
I20231121003941 VA Practitioner - Nurse Practitioner 7113325036 Reassigns benefits to 1 organization
I20250128000573 PA Practitioner - Nurse Practitioner 7113325036 Reassigns benefits to 1 organization
I20250211000432 MA Practitioner - Nurse Practitioner 7113325036 Reassigns benefits to 1 organization
I20250307003214 DC Practitioner - Nurse Practitioner 7113325036 Reassigns benefits to 1 organization
I20250718002392 GA Practitioner - Nurse Practitioner 7113325036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

1275 Hwy 54 W
Suite 201
Fayetteville, GA 30214-4538
Phone (770) 461-3776

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA066069PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Massachusetts Multi-Specialty CurrentSince Jan 1, 2025 Accepting new patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Jan 1, 2025 Accepting new patients
Peachtree Immediate Care FP, LLC Multi-Specialty CurrentSince Jul 9, 2025 Accepting new patients
Urgent Care, PC - Pennsylvania Multi-Specialty Current Accepting new patients
Medexpress Urgent Care, PC - Massachusetts CurrentSince Jan 1, 2025 Accepting new patients
Medexpress Urgent Care, PC - Maryland CurrentSince Sep 1, 2023 Accepting new patients
CRH MD Management LLC Multi-Specialty CurrentSince Mar 4, 2025 Accepting new patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Jan 1, 2025 Accepting new patients
Medexpress Urgent Care, PC - Maryland Multi-Specialty CurrentSince Sep 1, 2023 Accepting new patients
Medexpress Urgent Care, PC - Virginia Multi-Specialty CurrentSince Oct 1, 2023 Accepting new patients
Fast Pace Mississippi, PLLC Multi-Specialty CurrentSince Sep 3, 2021 Accepting new patients
CRH MD Management, LLC CurrentSince Mar 4, 2025 Accepting new patients
Medexpress Urgent Care, PC - Virginia CurrentSince Oct 1, 2023 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Sep 3, 2021 Accepting new patients

Locations

590 Lanier Ave W
Fayetteville, GA 30214

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

430 Cooley St
Springfield, MA 01128
Phone (413) 295-4144

99 Baughmans Ln
Frederick, MD 21702
Phone (301) 662-1392

1741 Dual Hwy
Ste A
Hagerstown, MD 21740
Phone (301) 790-0254

1741 Dual Hwy
Hagerstown, MD 21740
Phone (301) 337-7749

14421 Baltimore Ave
Laurel, MD 20707
Phone (240) 786-6684

11804 Reisterstown Rd
Reisterstown, MD 21136
Phone (410) 870-5094

14090 Hg Trueman Rd
Ste 1300
Solomons, MD 20688
Phone (410) 394-2800

3265 Highway 90
Gautier, MS 39553
Phone (228) 366-9136

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

1008 Azalea Dr
Waynesboro, MS 39367
Phone (601) 509-2584

4808 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-3072

7219 McKnight Rd
Ste F
Pittsburgh, PA 15237
Phone (412) 367-3278

1336 W Main St
Salem, VA 24153
Phone (540) 389-0374

423 Fortress Blvd
Morgantown, WV 26508
Phone (844) 852-9510

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1417629403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11217 KARLI LN",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395328026",
            "telephone_number": "228-257-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 DUAL HWY",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406624",
            "telephone_number": "301-337-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MELINDA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024188012",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "117249",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "PA066069",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2386999",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC005797",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904864",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417629403",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.