Individual provider Active NPI

Tawana Cooper, ARNP

  • Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1487656641
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP2858322 Issued in FL
Practice address
1619 Creighton Rd Ste 1
Pensacola, FL 32504-7152
Phone
(850) 444-4700
Fax
(850) 434-8144
NPI assigned
Jun 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP2858322 FL Primary

Addresses

Primary practice location

1619 Creighton Rd Ste 1
Pensacola, FL 32504-7152

Mailing address

1619 Creighton Rd Ste 1
Pensacola, FL 32504-7152
Phone (850) 444-4700

Other practice location 1

4304 Lancaster Dr
Niceville, FL 32578-4563
Phone (850) 862-2385

Other practice location 2

1717 N E St Ste 403
Pensacola, FL 32501-6334
Phone (850) 444-4700

Other practice location 3

2940 N Blue Angel Pkwy
Pensacola, FL 32506-2925
Phone (850) 444-4700

Other practice location 4

5149 N 9th Ave Ste G35
Pensacola, FL 32504-8733
Phone (850) 444-4700

Other practice location 5

6001 Industrial Blvd
Century, FL 32535-3312
Phone (850) 444-4700

Other practice location 6

5934 Berryhill Medical Park Dr # 1
Milton, FL 32570
Phone (850) 623-4771

Other practice location 7

14114 Alabama St
Jay, FL 32565-1219
Phone (850) 444-4700

Other practice location 8

319 Green Acres Rd Ste 103
Fort Walton Beach, FL 32547-1170
Phone (850) 862-2385

Other practice location 9

221 E Redstone Ave
Crestview, FL 32539-5373
Phone (850) 398-6606

Other practice location 10

2583 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3043
Phone (850) 444-4700

Other identifiers 3

IdentifierTypeStateIssuer
Y03TTOtherFLBCBSFL
30636400MedicaidFL
ARNP2858322OtherFLSTATE OF FLORIDA DOH LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040512000045 FL Practitioner - Nurse Practitioner 1153310354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pensacola Nephrology PAGroup PAC ID 7214832856, 37 clinicians

Practice addresses (Care Compare)

1619 Creighton Rd
Suite 1
Pensacola, FL 32504-7152
Phone (850) 444-4700

Hospital & facility affiliations

  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093
  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pensacola Nephrology, PA CurrentSince Jan 26, 2004 Accepting new patients
Pensacola Nephrology, PA CurrentSince Jan 26, 2004 Accepting new patients
Renal Care Group of the Southeast, Inc. Past Accepting new patients

Locations

6001 Industrial Blvd
Century, FL 32535
Phone (251) 943-2300

221 E Redstone Ave
Crestview, FL 32539
Phone (850) 398-6606

319 Green Acres Rd
#103
Fort Walton Beach, FL 32547

2583 Gulf Breeze Pkwy
Gulf Breeze, FL 32563
Phone (850) 934-1951

14114 Alabama St
Jay, FL 32565
Phone (850) 675-8000

4304 Lancaster Dr
Niceville, FL 32578
Phone (850) 729-4141

1619 Creighton Rd
Ste 1
Pensacola, FL 32504
Phone 85044447001730

2940 N Blue Angel Pkwy
Pensacola, FL 32506
Phone (850) 453-3658

1717 N E St
Ste 403
Pensacola, FL 32501

5149 N 9th Ave
Ste G35
Pensacola, FL 32504
Phone (850) 471-1445

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1487656641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 CREIGHTON RD STE 1",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325047152",
            "telephone_number": "850-444-4700",
            "fax_number": "850-444-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 CREIGHTON RD STE 1",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325047152",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4304 Lancaster Dr",
            "address_purpose": "LOCATION",
            "city": "Niceville",
            "state": "FL",
            "postal_code": "325784563",
            "country_code": "US",
            "telephone_number": "850-862-2385",
            "fax_number": "850-862-0482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1717 N E St Ste 403",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325016334",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2940 N Blue Angel Pkwy",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325062925",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5149 N 9th Ave Ste G35",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048733",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6001 Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Century",
            "state": "FL",
            "postal_code": "325353312",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5934 Berryhill Medical Park Dr # 1",
            "address_purpose": "LOCATION",
            "city": "Milton",
            "state": "FL",
            "postal_code": "32570",
            "country_code": "US",
            "telephone_number": "850-623-4771",
            "fax_number": "850-623-3938",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14114 Alabama St",
            "address_purpose": "LOCATION",
            "city": "Jay",
            "state": "FL",
            "postal_code": "325651219",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "319 Green Acres Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325471170",
            "country_code": "US",
            "telephone_number": "850-862-2385",
            "fax_number": "850-862-0482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "221 E Redstone Ave",
            "address_purpose": "LOCATION",
            "city": "Crestview",
            "state": "FL",
            "postal_code": "325395373",
            "country_code": "US",
            "telephone_number": "850-398-6606",
            "fax_number": "850-398-6424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2583 Gulf Breeze Pkwy",
            "address_purpose": "LOCATION",
            "city": "Gulf Breeze",
            "state": "FL",
            "postal_code": "325633043",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "TAWANA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2022-07-21",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2858322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "Y03TT",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30636400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA DOH LICENSE",
            "identifier": "ARNP2858322",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.