Amanda Cooper, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

25956 Issued in SC

Practice address

880 W Moultrie St Ste 200
Winnsboro, SC 29180-2411

Phone

(803) 635-6461

Fax

(803) 635-4200

NPI assigned

Sep 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Fairfield Medical Associates, LLC

  • Rural Health Clinic/Center
  • Winnsboro, SC
  • NPI 1184737892
  Medicare reassignment NPD
• Physician'S Pain and Spine Center, LLC

  • Interventional Pain Medicine Physician
  • West Coumbia, SC
  • NPI 1336475573
  NPD (past)

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1952073827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 GREENE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292084001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W MOULTRIE ST STE 200",
            "city": "WINNSBORO",
            "state": "SC",
            "postal_code": "291802411",
            "telephone_number": "803-635-6461",
            "fax_number": "803-635-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "25956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Shamara Cohen
• Laleisha Cohen, PHARMD
• Carrie Coles
• Communikay Speech Pathology LLC
• Community Cornerstone
• Donald Crawford
• Davis and Davis Health Center
• Kathleen M Dean, LISW-CP
• Brenna B. Delaine, M.D.
• Maria Shields Dickerson, O.D.

• Family Nurse Practitioner in Winnsboro, SC
• Providers in Winnsboro, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.