Individual provider Active NPI

Janice Marion Cooper

  • Psychologist
  • Wescosville, PA
National Provider Identifier
1558396945
Registry record updated May 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS 001285-L Issued in PA
Practice address
4949 Liberty LN
Suite 5
Wescosville, PA 18106-9014
Phone
(610) 821-9422
Fax
(610) 820-6308
NPI assigned
Jul 12, 2006
Last updated
May 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS 001285-L PA Primary

Addresses

Primary practice location

4949 Liberty LN
Suite 5
Wescosville, PA 18106-9014

Mailing address

4949 Liberty Lane
Suite 5
Wescosville, PA 18106-9017
Phone (610) 821-9422

Other identifiers 11

IdentifierTypeStateIssuer
01744201OtherPACAPITAL BLUE CROSS
7160053OtherPAAETNA
P3300773OtherPAOXFORD
1034698OtherPACIGNA
132334000OtherPAMAGELLAN
0059905000OtherPAINDEPENDENCE BLUE CROSS
1664534OtherPAAMERIHEALTH
338509OtherPAHIGHMARK BLUE SHIELD
1394296MedicaidPA
164557OtherPAVALUE OPTIONS
254837OtherPAMANAGED HEALTH NETWORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160428001878 PA Practitioner - Psychologist Billing Independently 2062711849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4949 Liberty Lane
Suite 5
Wescosville, PA 18106-9017

4949 Liberty LN
Suite 5
Allentown, PA 18106-9017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS 001285-LPAMDPsychologist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1558396945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 LIBERTY LANE",
            "address_2": "SUITE 5",
            "city": "WESCOSVILLE",
            "state": "PA",
            "postal_code": "181069017",
            "telephone_number": "610-821-9422",
            "fax_number": "610-820-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 LIBERTY LN",
            "address_2": "SUITE 5",
            "city": "WESCOSVILLE",
            "state": "PA",
            "postal_code": "181069014",
            "telephone_number": "610-821-9422",
            "fax_number": "610-820-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JANICE",
        "middle_name": "MARION",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS 001285-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "01744201",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7160053",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3300773",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1034698",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "132334000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0059905000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "1664534",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "338509",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1394296",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "164557",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "254837",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wescosville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.