Ekeoma I Cooper

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

76499 Issued in NM

Practice address

6500 Northwest Dr Ste 350
Mesquite, TX 75150-1364

Phone

(972) 373-4191

Fax

(972) 373-4569

NPI assigned

Feb 14, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, NM2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Complex Wound Solutions, LLCGroup PAC ID 8325578388, 4 clinicians

Frank S Floca MD PLLCGroup PAC ID 3779754163, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Homeland Home Health Agency Inc Home health agency, Garland, TX, CCN 677825
• New Heights Healthcare Agency Home health agency, Dallas, TX, CCN 457872
• Hendrick Medical Center Hospital, Abilene, TX, CCN 450229

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Frank S Floca MD PLLC

  • Psychiatry Physician
  • Austin, TX
  • NPI 1770878043

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Premiercare Medical Clinic

  • Nurse Practitioner
  • Mesquite, TX
  • NPI 1346898418

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Roann Behavioral Health Clinic PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mesquite, TX
  • NPI 1962129288

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Complex Wound Solutions, LLC

  • Family Nurse Practitioner
  • Casper, WY
  • NPI 1104644228

  Multi-Specialty, TX

  Medicare reassignment Care Compare group NPD
• Core Healthcare Solutions PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chandler, AZ
  • NPI 1821829508

  Multi-Specialty

  NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hendrick Medical Center

  • General Acute Care Hospital
  • Abilene, TX
  • NPI 1528064649
  Care Compare affiliation
• Homeland Home Health Agency Inc

  • Home Health Agency
  • Garland, TX
  • NPI 1003926544
  Care Compare affiliation
• New Heights Homecare Solutions

  • Home Health Agency
  • Dallas, TX
  • NPI 1104859719
  Care Compare affiliation

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1578029534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 NORTHWEST DR STE 350",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751501364",
            "telephone_number": "972-373-4191",
            "fax_number": "972-373-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 NORTHWEST DR STE 350",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751501364",
            "telephone_number": "972-373-4191",
            "fax_number": "972-373-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "EKEOMA",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP137926",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP137926",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP137926",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "76499",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NM",
            "license": "76499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408712401",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "getpremiercare@gmail.com",
            "affiliation": "N",
            "endpointDescription": "PremierCare Medical Clinic",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Mail",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Mails",
            "address_1": "6500 Northwest Dr Ste 350",
            "city": "Mesquite",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751501364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sami Elias Constantine, M.D.
• Elvira Bucton Constantino
• Marian Boko Conteh
• Candece Cooper-Charles, LPC
• Abigail Cooper, RN
• Lillian M Coover, PA
• John Nelson Copeland
• Cora a Marsaw DDS PA
• Flor Guadalupe Cordova
• Joseph Earl Corley Jr.

• Gerontology Nurse Practitioner in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.
• 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.