Individual provider Active NPI

Donlandra Olexis Cooper, PA

  • Physician Assistant
  • Fredericksburg, VA
National Provider Identifier
1801306378
Registry record updated Dec 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006603 Issued in VA
Practice address
1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone
(540) 741-1100
NPI assigned
Oct 10, 2017
Last updated
Dec 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X GA
Physician Assistant 363A00000X 0110006603 VA Primary
Physician Assistant 363A00000X 021381 NY

Addresses

Primary practice location

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453

Mailing address

10516 Abberly Village LN Apt 322
Fredericksburg, VA 22407-2725
Phone (585) 613-2670

Other practice location 1

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-4912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VA, GA, DC4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20180504000040 NY Practitioner - Physician Assistant 2769742030 Reassigns benefits to 1 organization
I20191120001050 VA Practitioner - Physician Assistant 2769742030 Reassigns benefits to 3 organizations
I20230608000067 GA Practitioner - Physician Assistant 2769742030 Reassigns benefits to 1 organization
I20250312001103 DC Practitioner - Physician Assistant 2769742030 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, shared by 24 NPIs, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

4320 Seminary Rd
Alexandria, VA 22304-1535

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
021381NYMDClinical Psychologist
0110006603VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Mar 31, 2025 Accepting new patients
The Emory Clinic Inc CurrentSince Apr 10, 2023 Accepting new patients
Inova Health Care Services CurrentSince Mar 31, 2025 Accepting new patients
Internal Medicine Group CurrentSince Apr 1, 2018 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
Inova Health Care Services CurrentSince Mar 31, 2025 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
Inova Health Care Services CurrentSince Mar 31, 2025 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

8101 Hinson Farm Rd
Ste 415
Alexandria, VA 22306
Phone (703) 799-4000

8109 Tis Well Dr
Ste 511
Alexandria, VA 22306
Phone (703) 799-4000

3833 Fairfax Dr
Ste 200
Arlington, VA 22203
Phone (703) 525-8863

3833 Fairfax Dr
Ste 201
Arlington, VA 22203
Phone (703) 351-9424

3800 Fettler Park Dr
Ste 312
Dumfries, VA 22025
Phone (571) 472-6791

3620 Joseph Siewick Dr
Ste 400
Fairfax, VA 22033
Phone (703) 264-7801

8081 Innovation Park Dr
Ste 900
Fairfax, VA 22031
Phone (571) 472-4200

8095 Innovation Park Dr
Bldg C
Fairfax, VA 22031
Phone (571) 472-6253

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

7051 Heathcote Village Way
Ste 230
Gainesville, VA 20155
Phone (703) 391-4500

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670025600000",
    "number": "1801306378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10516 ABBERLY VILLAGE LN APT 322",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224072725",
            "telephone_number": "585-613-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SAM PERRY BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014453",
            "telephone_number": "540-741-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-4912",
            "fax_number": "585-276-2144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "DONLANDRA",
        "middle_name": "OLEXIS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2022-12-03",
        "certification_date": "2022-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006603",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021381",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.