Active NPI
Andrea R. Cooper, APRN.CNM, APRN.CNP
- Advanced Practice Midwife
- Gahanna, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- APRN.CNM.13981
- Practice address
- 920 N Hamilton Rd
Gahanna, OH 43230-1757 - Phone
- (614) 293-3069
- Fax
- (614) 366-0894
- NPI assigned
- Sep 11, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN.CNP.14052 | OH | |
| Advanced Practice Midwife | 367A00000X | APRN.CNM.13981 | OH | Primary |
Addresses
Primary practice location
920 N Hamilton Rd
Gahanna, OH 43230-1757
Mailing address
700 Ackerman Rd Ste 570
Columbus, OH 43202-1579
Phone (614) 293-3069
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0075201 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.14052 | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Hospital System, Inc | Current | Accepting new patients | |
| Lake Hospital System Inc | Nurse Practitioner | Current | Accepting new patients |
| Osu Internal Medicine, LLC | Past | Accepting new patients |
Locations
9485 Mentor Ave
Ste 202
Mentor, OH 44060
Phone (440) 205-5862
10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656
36001 Euclid Ave
Ste C7
Willoughby, OH 44094
Phone (440) 602-6710
36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166
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.
-
- Family Medicine Physician
- Middlefield, OH
- NPI 1952339996
Nurse Practitioner
-
- Urgent Care Clinic/Center
- Chardon, OH
- NPI 1689634966
-
- Internal Medicine Physician
- Columbus, OH
- NPI 1740231448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539043200000",
"number": "1508116203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 ACKERMAN RD STE 570",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432021579",
"telephone_number": "614-293-3069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 N HAMILTON RD",
"city": "GAHANNA",
"state": "OH",
"postal_code": "432301757",
"telephone_number": "614-293-3069",
"fax_number": "614-366-0894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "ANDREA",
"middle_name": "R.",
"credential": "APRN.CNM, APRN.CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-11",
"last_updated": "2018-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "APRN.CNP.14052",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "OH",
"license": "APRN.CNM.13981",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0075201",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gahanna, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.