Jennifer Brearley Cooper, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1973 Issued in SC

Practice address

14 Richland Medical Park Dr Ste 200
Columbia, SC 29203-6882

Phone

(803) 296-9200

NPI assigned

Jul 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jennifer Lynn Brearley Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcooper378299@direct.ghs.myhfn.org

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.

• Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
  • NPI 1275988321
  Medicare reassignment Care Compare group NPD (past)
• Prisma Health Medical Group-Midlands

  • Orthopaedic Surgery Physician
  • Columbia, SC
  • NPI 1346761897
  NPD
• Prisma Health Medical Group-Midlands

  dba PH Dentistry

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1881469856
  NPD

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1720420284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036882",
            "telephone_number": "803-296-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Saluda Pointe Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "SC",
            "postal_code": "290727295",
            "country_code": "US",
            "telephone_number": "803-227-8173",
            "fax_number": "803-227-8034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Saluda Pointe Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "SC",
            "postal_code": "290727295",
            "country_code": "US",
            "telephone_number": "803-227-8173",
            "fax_number": "803-227-8034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JENNIFER",
        "middle_name": "BREARLEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1708PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcooper378299@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jcooper378299@direct.ghs.myhfn.org",
            "address_1": "14 Richland Medical Park Dr Ste 200",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292036882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BREARLEY",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chelsea Danielle Cooper
• Ebony Cooper, MSW
• George A Cooper, PHARMD
• Janet M. Cooper, APRN
• Janiya Malasia Cooper, RBT
• Jessie Cooper, APRN
• Joshua Matthew Cooper, M.D.
• Kayla Marie Cooper, D.C.
• Marc Cooper, M.D.
• Noble P Cooper Jr., D.D.S.

• Physician Assistant in Columbia, SC
• Providers in Columbia, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.