Jeremy Cooper, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

298430 Issued in AZ

Practice address

238 Brookley Ave SW
Bolling AFB, DC 20032-7704

Phone

(202) 767-0611

NPI assigned

Jun 13, 2021

Last updated

Jul 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1623542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1720656143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 BROOKLEY AVE SW",
            "city": "BOLLING AFB",
            "state": "DC",
            "postal_code": "200327704",
            "telephone_number": "202-767-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 BROOKLEY AVE SW",
            "city": "BOLLING AFB",
            "state": "DC",
            "postal_code": "200327704",
            "telephone_number": "202-767-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-13",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "298430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerard Albert Caron, D.M.D.
• Artemio Cerda Chapa, M.D.
• Thomas Norman Cheatham, M.D.
• John Lloyd Chitwood, PA
• Amanda Nicole Collins, PA-C
• Timothy Corcoran, M.D.
• Robert J Cubilla, LMSW
• Margaret Alisa Curry, DMD
• Kevin M Davis Jr.
• Kurtis Lee Dean, PA-C

• Psychiatric/Mental Health Nurse Practitioner in Bolling AFB, DC
• Providers in Bolling AFB, DC by specialty
• Psychiatric/Mental Health Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.