Individual provider Active NPI

Cristin Cooper, FNP

  • Family Nurse Practitioner
  • New Albany, MS
National Provider Identifier
1821514506
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902319 Issued in MS
Practice address
210 Hwy 30 W
New Albany, MS 38652-3112
Phone
(662) 539-7014
NPI assigned
Aug 15, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 902319 MS Primary

Addresses

Primary practice location

210 Hwy 30 W
New Albany, MS 38652-3112

Mailing address

1008 Kendall St
Amory, MS 38821-2606

Other practice location 1

1008 Kendall St
Amory, MS 38821-2606
Phone (662) 315-5476

Other practice location 2

1008 Kendall St
Amory, MS 38821-2606
Phone (662) 315-5476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20181002001093 MS Practitioner - Nurse Practitioner 2365793346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State Urgent Care, LLCGroup PAC ID 1557675311, 13 clinicians
Amory Urgent Care, LLCGroup PAC ID 6305071143, 3 clinicians

Practice addresses (Care Compare)

521 S Montgomery St
Starkville, MS 39759-3337
Phone (662) 338-4826

906 Hwy 278 E
Amory, MS 38821-5511
Phone (662) 256-5612

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.92 of 100Reported as group
Quality
78.78
Improvement activities
40
Cost
78.02

Merit-based Incentive Payment System (MIPS)

Final score
88.37 of 100Reported as individual
Quality
84.3
Promoting interoperability
100
Improvement activities
40
Cost
76.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
902319MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amory Urgent Care, LLC CurrentSince Nov 12, 2018 Accepting new patients
State Urgent Care, LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

906 Highway 278 E
Amory, MS 38821
Phone (662) 200-8464

521 S Montgomery St
Starkville, MS 39759
Phone (662) 338-4826

Interoperability endpoints

  • Direct secure messaging: cristin.cooper.1@11573.direct.athenahealth.com
  • Direct secure messaging: cristin.cooper.1@7547.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11573/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/7547/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1821514506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 KENDALL ST",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388212606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 HWY 30 W",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523112",
            "telephone_number": "662-539-7014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 Kendall St",
            "address_purpose": "LOCATION",
            "city": "Amory",
            "state": "MS",
            "postal_code": "388212606",
            "country_code": "US",
            "telephone_number": "662-315-5476",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1008 Kendall St",
            "address_purpose": "LOCATION",
            "city": "Amory",
            "state": "MS",
            "postal_code": "388212606",
            "country_code": "US",
            "telephone_number": "662-315-5476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CRISTIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

Verify at the official NPI Registry.