Individual provider Active NPI

Jessica Cooper, RN

  • Registered Nurse
  • Arcata, CA
National Provider Identifier
1457722951
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95069669 Issued in CA
Practice address
770 10TH St
Arcata, CA 95521-6210
Phone
(707) 826-8610
Fax
(707) 826-8623
NPI assigned
Oct 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95069669 CA Primary

Addresses

Primary practice location

770 10TH St
Arcata, CA 95521-6210

Mailing address

670 9TH St
Suite 203
Arcata, CA 95521-6248
Phone (707) 826-8633

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95069669CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1457722951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST",
            "address_2": "SUITE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216248",
            "telephone_number": "707-826-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 10TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216210",
            "telephone_number": "707-826-8610",
            "fax_number": "707-826-8623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JESSICA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95069669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcata, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.