NPIMap

Individual provider Active NPI

Jody Coomer, APRN

  • Family Nurse Practitioner
  • Lebanon, KY
National Provider Identifier
1962863407
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3009967 Issued in KY
Practice address
325 W Walnut St
Ste. 600
Lebanon, KY 40033-1377
Phone
(270) 699-9500
NPI assigned
Mar 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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 3009967 KY Primary

Addresses

Primary practice location

325 W Walnut St
Ste. 600
Lebanon, KY 40033-1377

Mailing address

325 W Walnut St
Ste. 600
Lebanon, KY 40033-1377
Phone (270) 699-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160421000890 KY Practitioner - Nurse Practitioner 4880991488 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ephraim McDowell Health Resource Inc 161 clinicians

Practice addresses (Care Compare)

120 Daniel Dr
Danville, KY 40422-2527
Phone (859) 239-5570

Hospital & facility affiliations

  • Ephraim McDowell Regional Medical Center Hospital, Danville, KY, CCN 180048
  • The James B. Haggin Memorial Hospital Hospital, Harrodsburg, KY, CCN 181302
  • Ephraim McDowell Fort Logan Hospital Hospital, Stanford, KY, CCN 181315

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ephraim McDowell Health Resource, Inc Family CurrentSince Oct 14, 2024 Accepting new patients
Advanced Family Medical Clinic Mount Vernon CurrentSince Sep 15, 2022 Accepting new patients
Lake Cumberland Regional Hospital LLC CurrentSince Jun 1, 2021 Accepting new patients
Waynesburg Clinic, PLLC CurrentSince Oct 10, 2018 Accepting new patients
Lake Cumberland Physician Practices LLC CurrentSince Mar 1, 2020 Accepting new patients
Ephraim McDowell Health Resource, Inc Family CurrentSince Oct 14, 2024 Accepting new patients
Lake Cumberland Physician Practices, LLC Current Accepting new patients
Lake Cumberland Regional Hospital LLC Family CurrentSince Jun 1, 2021 Accepting new patients
Ephraim McDowell Health Resource, Inc. Family Current Accepting new patients
Lake Cumberland Regional Hospital LLC Family Current Accepting new patients
Lake Cumberland Physician Practices LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

120 Daniel Dr
Danville, KY 40422
Phone (859) 236-0903

216 W Walnut St
Ste A
Danville, KY 40422
Phone (859) 239-5870

353 Bogle St
Ste A
Somerset, KY 42503
Phone (606) 451-3820

30 Tower Cir
Somerset, KY 42503
Phone (606) 451-8644

350 Hospital Way
Ste 100
Somerset, KY 42503
Phone (606) 451-2600

79 Sarahs Ln
Somerset, KY 42503
Phone (606) 386-1917

14098 US Highway 27 S
Waynesburg, KY 40489
Phone (606) 379-6646

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21269/brand/3/csg/1/fhir/r4

Organizations & group practices 12

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.

Hospital & facility affiliations 9

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": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1962863407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W WALNUT ST",
            "address_2": "STE. 600",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331377",
            "telephone_number": "270-699-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W WALNUT ST",
            "address_2": "STE. 600",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331377",
            "telephone_number": "270-699-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMER",
        "first_name": "JODY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, KY

Sources for this page

Verify at the official NPI Registry.