Individual provider Active NPI

Molly Van Wert Cooper, FNP-C

  • Nurse Practitioner
  • Adairsville, GA
National Provider Identifier
1891395505
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN238758 Issued in GA
Practice address
115 N Central Ave
Adairsville, GA 30103-2467
Phone
(470) 601-5750
Fax
(770) 877-3655
NPI assigned
Oct 30, 2020
Last updated
Dec 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN238758 GA Primary

Addresses

Primary practice location

115 N Central Ave
Adairsville, GA 30103-2467

Mailing address

221 Technology Pkwy NW
Rome, GA 30165-1369
Phone (762) 235-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address molly.cooper.1@1498.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20221206001574 GA Practitioner - Nurse Practitioner 0244609790 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harbin Clinic, LLC Current Accepting new patients
Harbin Clinic, LLC CurrentSince Nov 28, 2022 Accepting new patients
Harbin Clinic, LLC CurrentSince Nov 28, 2022 Accepting new patients

Locations

115 N Central Ave
Adairsville, GA 30103
Phone (470) 601-5650

101 Redmond Rd NW
Rome, GA 30165
Phone (706) 290-1330

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

221 Technology Pkwy NW
Rome, GA 30165
Phone (762) 235-1000

Interoperability endpoints

  • Direct secure messaging: mcooper3004850@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: molly.cooper.1@1498.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1891395505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N CENTRAL AVE",
            "city": "ADAIRSVILLE",
            "state": "GA",
            "postal_code": "301032467",
            "telephone_number": "470-601-5750",
            "fax_number": "770-877-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MOLLY",
        "middle_name": "VAN WERT",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN238758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "molly.cooper.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "115 N Central Ave",
            "city": "Adairsville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301032467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Adairsville, GA

Sources for this page

Verify at the official NPI Registry.