Crystal Ann Cooper, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19111 Issued in TN

Practice address

39 Cumberland Gap PLZ
Gray, KY 40734-4536

Phone

(606) 526-9005

Fax

(606) 526-8607

NPI assigned

Nov 1, 2012

Last updated

May 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alignmed Medical Group, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Baltimore, MD
  • NPI 1366289423

  TN

  Medicare reassignment NPD
• Alignmed Partners, PC

  dba GPS Physician Group PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Gardendale, AL
  • NPI 1881109452

  TN

  Medicare reassignment NPD
• Genesis Eldercare Physician Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • La Follette, TN
  • NPI 1790188076
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  TN

  Medicare reassignment NPD
• Genesis Eldercare Physician Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Towson, MD
  • NPI 1699280511
  NPD

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1699029462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1325",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407021325",
            "telephone_number": "606-526-8131",
            "fax_number": "606-528-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 CUMBERLAND GAP PLZ",
            "city": "GRAY",
            "state": "KY",
            "postal_code": "407344536",
            "telephone_number": "606-526-9005",
            "fax_number": "606-526-8607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CRYSTAL",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007739",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K068550",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100225480",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q007160",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Baker, APRN, FNP-C
• Hannah Campbell Barger
• Veronica L Boley, APRN
• Danny Meloyd Bryant
• Erin Chadwell, MS, RD, LD
• Angela Eversole, APRN
• Freeman Family Practice LLC
• Tammy L Freeman, APRN
• Melissa Garland
• Natasha Garrison, APRN

• Family Nurse Practitioner in Gray, KY
• Providers in Gray, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.

Verify at the official NPI Registry.