Jeniesha Cooper, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

27072457A Issued in GA

Practice address

1607 Barrington VW
Stone Mountain, GA 30087-1846

Phone

(678) 582-9317

Fax

(678) 705-3735

NPI assigned

Apr 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Royal Care Service, LLC

  • Home Health Agency
  • Stone Mountain, GA
  • NPI 1306414677
  NPD

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

{
    "created_epoch": "1649462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649462400000",
    "number": "1992447023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 BARRINGTON VW",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871846",
            "telephone_number": "678-582-9317",
            "fax_number": "678-705-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 BARRINGTON VW",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871846",
            "telephone_number": "678-582-9317",
            "fax_number": "678-705-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JENIESHA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-09",
        "last_updated": "2022-04-09",
        "certification_date": "2022-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "27072457A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003258912A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@royalcareservice.org",
            "affiliation": "Y",
            "affiliationName": "Royal Care Service, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1607 Barrington Vw",
            "city": "Stone Mountain",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300871846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Concoh Health Care
• Connection Bridge Oasis, Inc.
• Christopher Connelly, D.C.
• Carla N Cooke, PA-C
• Carmen Cooper, MA
• Tanisha Chantal Cooper, PHARMD.
• Della Corbin-Johnson, RPH
• Edward A Corkran, D.O.
• Ray Cornay, D.M.D.
• Costco Wholesale Corporation

• Licensed Practical Nurse in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2022; 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.