Individual provider Active NPI

Andria Jolly-Morris, FNP

  • Family Nurse Practitioner
  • Cooperstown, NY
National Provider Identifier
1427890847
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F354171-01 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326-1394
Phone
(607) 547-3456
NPI assigned
Jun 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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 F354171-01 NY Primary

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326-1394

Mailing address

401 E 86TH St Apt 19F
New York, NY 10028-6426
Phone (360) 731-3890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250418000555 NY Practitioner - Nurse Practitioner 9032634472

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1301

1 Atwell Rd
Cooperstown, NY 13326-1394

331 Newman Springs Rd
Red Bank, NJ 07701-5688

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F354171-01NYMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: ajollymorris559064@bassett.direct-ci.net

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1717718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1427890847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 86TH ST APT 19F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100286426",
            "telephone_number": "360-731-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261394",
            "telephone_number": "607-547-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY-MORRIS",
        "first_name": "ANDRIA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F354171-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.