Individual provider Active NPI

Janet Cooper

  • Family Nurse Practitioner
  • Banning, CA
National Provider Identifier
1487085403
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP 23794 Issued in CA
Practice address
5957 W Ramsey St
Banning, CA 92220-3058
Phone
(951) 845-0313
NPI assigned
Dec 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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 NP 23794 CA Primary

Addresses

Primary practice location

5957 W Ramsey St
Banning, CA 92220-3058

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 335-4188

Other practice location 1

12677 Hesperia Rd
Victorville, CA 92395-7735
Phone (760) 952-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180403001690 CA Practitioner - Nurse Practitioner 6002105467 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP 23794CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Medical Group P C CurrentSince Mar 1, 2018 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Beaver Medical Group P C CurrentSince Mar 1, 2018 Accepting new patients
Beaver Medical Group P C Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

6109 W Ramsey St
Banning, CA 92220
Phone (909) 845-0313

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1615 Orange Tree Ln
Redlands, CA 92374
Phone (909) 335-4102

2 W Fern Ave
#1112
Redlands, CA 92373

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1385856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1487085403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5957 W RAMSEY ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203058",
            "telephone_number": "951-845-0313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12677 Hesperia Rd",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923957735",
            "country_code": "US",
            "telephone_number": "760-952-0040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JANET",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-01",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP 23794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Banning, CA

Sources for this page

Verify at the official NPI Registry.