Individual provider Active NPI

Kristina Ellen Cooper, RN

  • Registered Nurse
  • Eagle, CO
National Provider Identifier
1942915905
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.0121834 Issued in CO
Practice address
551 Broadway St
Eagle, CO 81631-0660
Phone
(970) 328-8840
Fax
(855) 848-8829
NPI assigned
Jan 13, 2023
Last updated
Jan 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.0121834 CO Primary

Addresses

Primary practice location

551 Broadway St
Eagle, CO 81631-0660

Mailing address

PO Box 660
Eagle, CO 81631-0660
Phone (970) 328-8840

Other identifiers 1

IdentifierTypeStateIssuer
04445094MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address diseaseprevention@eaglecounty.us

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.0121834COMDRegistered Nurse

Interoperability endpoints

  • Direct secure messaging: diseaseprevention@eaglecounty.us

NPI Registry JSON

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1942915905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660",
            "city": "EAGLE",
            "state": "CO",
            "postal_code": "816310660",
            "telephone_number": "970-328-8840",
            "fax_number": "855-848-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 BROADWAY ST",
            "city": "EAGLE",
            "state": "CO",
            "postal_code": "816310660",
            "telephone_number": "970-328-8840",
            "fax_number": "855-848-8829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KRISTINA",
        "middle_name": "ELLEN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0121834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04445094",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diseaseprevention@eaglecounty.us",
            "affiliation": "N",
            "address_1": "551 Broadway",
            "city": "Eagle",
            "state": "CO",
            "country_code": "US",
            "postal_code": "816310660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eagle, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.