Individual provider Active NPI

Stacie Rene Cooper, FNP-C

  • Family Nurse Practitioner
  • Odessa, TX
National Provider Identifier
1770436487
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1227172 Issued in TX
Practice address
540 W 5TH St Ste 350
Odessa, TX 79761-5050
Phone
(432) 337-3117
NPI assigned
Feb 20, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1227172 TX Primary

Addresses

Primary practice location

540 W 5TH St Ste 350
Odessa, TX 79761-5050

Mailing address

PO Box 2129
Odessa, TX 79760-2129
Phone (432) 337-3117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260317003427 TX Practitioner - Nurse Practitioner 4082198106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9907 Holiday Dr
Odessa, TX 79765-2008

PO Box
Suite 2129
Odessa, TX 79760

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1227172TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCH Professional Care CurrentSince Mar 1, 2026 Accepting new patients

Locations

540 W 5th St
Ste 350
Odessa, TX 79761
Phone (432) 332-7500

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1771545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1770436487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797602129",
            "telephone_number": "432-337-3117",
            "fax_number": "432-640-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W 5TH ST STE 350",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615050",
            "telephone_number": "432-337-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "STACIE",
        "middle_name": "RENE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-20",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1227172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.