Individual provider Active NPI

Jennifer Lynn Cooper, AGNP-C

  • Adult Health Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1609653831
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
200608 Issued in SD
Practice address
4800 E 57TH St Ste B
Sioux Falls, SD 57108-8627
Phone
(605) 305-4080
NPI assigned
Sep 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 200608 SD Primary
Gerontology Nurse Practitioner 363LG0600X 200608 SD
Primary Care Nurse Practitioner 363LP2300X 200608 SD

Addresses

Primary practice location

4800 E 57TH St Ste B
Sioux Falls, SD 57108-8627

Mailing address

309 S Wipf St
Freeman, SD 57029-2011
Phone (440) 220-2765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20251111003090 CO Practitioner - Nurse Practitioner 3779074356

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6870 W 52ND Ave
Arvada, CO 80002-3952

9250 E Costilla Ave
Suite 540
Greenwood Village, CO 80112-3648

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200608SDMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Consultants Aco Prof LLC Current Accepting new patients

Locations

9250 E Costilla Ave
Ste 540
Greenwood Village, CO 80112

12230 Lioness Way
Parker, CO 80134
Phone (720) 214-7777

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1609653831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 S WIPF ST",
            "city": "FREEMAN",
            "state": "SD",
            "postal_code": "570292011",
            "telephone_number": "440-220-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 E 57TH ST STE B",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088627",
            "telephone_number": "605-305-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SD",
            "license": "200608",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SD",
            "license": "200608",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SD",
            "license": "200608",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.