Estacia D Cooper
Estacia Diann Thrower · Nurse Practitioner (Obstetrics & Gynecology)

Address: 5054 Waterford Place Dr, Sheffield Village, OH 44035-1494
Phone: 4409348344

Estacia D Cooper (NPI# 1316196959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1316196959
Entity Type Individual
Full Name Estacia D Cooper
Other Name Estacia Diann Thrower
Credential CNP
Gender Female
Practice Address 5054 Waterford Place Dr
Sheffield Village
OH 44035-1494
Practice Telephone 4409348344
Practice Fax Number 4409348345
Mailing Address Po Box 636643
Cincinnati
OH 45263-6643
Mailing Telephone 4409893801
Mailing Fax Number 4409600264
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2008-09-18
Last Update Date 2015-11-03

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363LX0001X Nurse Practitioner · Obstetrics & Gynecology Physician Assistants & Advanced Practice Nursing Providers 80155 OK
No 364S00000X Clinical Nurse Specialist Physician Assistants & Advanced Practice Nursing Providers 80155 OK

Other Provider Identifier

State Identifier Issuer Type Code
OH 3025372 MEDICAID
OH 0083912 MEDICAID

Physician Overview

NPI 1316196959
PAC ID by PECOS 4981756640
Professional Enrollment ID I20121210000008
Full Name Estacia Diann Cooper
Organization Legal Name MERCY HEALTH PHYSICIANS LORAIN LLC
Phone Number 4409885226
Gender F
Graduation Year 2008
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 1355474172
Number of Group Practice Members 101
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
360172 MERCY REGIONAL MEDICAL CENTER
360145 UNIVERSITY HOSPITALS - ELYRIA MEDICAL CENTER

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
PQRS_EP_130_1 Documentation of Current Medications in the Medical Record 92%
PQRS_EP_226_1 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 100%

Office Location

Street Address 5054 WATERFORD PLACE DR
City SHEFFIELD VILLAGE
State OH
Zip Code 44035-1494

Providers in the same location

NPI Name Taxonomy Address Enumeration
1962488130 Tracy Ann Carter Obstetrics & Gynecology 5054 Waterford Place Dr, Sheffield Village, OH 44035 2005-12-20
1821074741 Corie Lynn Kovach Obstetrics & Gynecology 5054 Waterford Place Dr, Sheffield Village, OH 44035 2005-12-22

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NPI Name Taxonomy Address Enumeration
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1124438791 Ann Pecsok Physical Therapist 42101 Griswold Rd., Elyria, OH 44035 2014-05-05
1346589066 Catherine M Hollan Licensed Practical Nurse 39020 Chestnut Ridge Road, Elyria, OH 44035 2013-02-01
1639413453 Elyria Mediclinic Clinic/Center 156 Cleveland Street, Elyria, OH 44035 2012-11-16
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1881956670 Supriya Marie Mahajan Psychiatry & Neurology 673 East River Street, Elyria, OH 44035 2012-06-08
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Taxonomy Information

Taxonomy Code 363LX0001X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Obstetrics & Gynecology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1861664385 Suzanne Marie Elliott Nurse Practitioner 6803 Mayfield Rd Ste 112, Mayfield Heights, OH 44124-2211 2008-03-25
1912058777 Rhonda Sue Eubank Nurse Practitioner 3120 Parkway St Nw Ste A, Canton, OH 44708-3982 2007-01-16
1679657514 Kristine M Stephens Nurse Practitioner 310 Tappan St, Columbus, OH 43201-3346 2006-10-25
1790720316 Brenda Lee Gatchel Nurse Practitioner 960 S Prospect St, Marion, OH 43302-6225 2006-06-18
1114984234 Lillian Miranda Hesler Nurse Practitioner 5 East Liberty Street, Cincinnati, OH 45202 2006-05-01
1447238555 Sarah Wilson Nurse Practitioner 199 William Howard Taft Rd, Cincinnati, OH 45219-2103 2006-01-09
1124009907 Denise Anne Salisbury Nurse Practitioner 411 Oak St, Sterling Medical Associates, Attn: Credentials, Cincinnati, OH 45219-2598 2005-11-09
1609875459 Michelle Joy Slider Nurse Practitioner 2094 E State St, Suite B, Salem, OH 44460-4409 2005-07-14
1174529853 Angela F Rothstein Nurse Practitioner 5 W Wenger Rd, Ste D, Englewood, OH 45322-2723 2005-06-27
1306315007 Sarah Michelle Williams Nurse Practitioner 9312 Winton Rd, Cincinnati, OH 45231-3978 2018-11-26
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Competitor

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City SHEFFIELD VILLAGE
Zip Code 44035

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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