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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACEY COOPER
NPI 1689486458
Physician Assistant - Medical in Williamsburg, KY

Active since January 21, 2025PECOS Enrolled
475 N HIGHWAY 25 W STE 100, WILLIAMSBURG, KY 40769(606) 549-2930 Get Directions Write a Review

NPPES record last updated: July 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 20, 2026, Jun 4, 2026, Jan 6, 2026 (3 updates tracked since 2026).

About Jacey Cooper NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACEY COOPER (NPI 1689486458) is an individual medical provider in Williamsburg, Kentucky, licensed in Kentucky (PA3827) and active in the NPI registry since January 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1689486458
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameJACEY COOPER
Location Address475 N HIGHWAY 25 W STE 100Williamsburg, KY 40769-1576
Mailing AddressPo Box 247Jellico, TN 37762-0247
Phone(606) 549-2930
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateJanuary 21, 2025
Last NPPES UpdateJuly 20, 20263 updates tracked since enumeration
NPPES CertifiedJuly 20, 2026
✔ NPI 1689486458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Licenses✔ Licensed in KY · PA3827✔ Licensed in TN · 7082
475 N HIGHWAY 25 W STE 100, Williamsburg, KY 40769
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacey Cooper is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6002391554
PECOS Enrollment IDI20260401003262
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. SHEILA DENISE LAMBDIN APRN
Nurse Practitioner
475 N HIGHWAY 25 W STE 100
WILLIAMSBURG, KY 40769
Whitley County (606) 549-2930
WILLIAMSBURG FAMILY MEDICINE CENTER
Clinic/Center (Rural Health)
475 N HIGHWAY 25 W STE 100
WILLIAMSBURG, KY 40769
Whitley County (606) 549-2933
MR. AARON DEWAYNE PETREY PA-C
Physician Assistant (Medical)
475 N HIGHWAY 25 W STE 100
WILLIAMSBURG, KY 40769
Whitley County (606) 549-2930
TAYLOR R PERKINS PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
475 N HIGHWAY 25 W STE 100
WILLIAMSBURG, KY 40769
Whitley County (606) 549-2930

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacey Cooper's NPI number?

The NPI number for Jacey Cooper is 1689486458. It was assigned to this individual provider in the NPPES registry on January 21, 2025.

Where is Jacey Cooper located?

Jacey Cooper practices at 475 N Highway 25 W Ste 100, Williamsburg, KY 40769. The listed phone number is (606) 549-2930.

What is Jacey Cooper's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jacey Cooper enrolled in Medicare?

Yes. Jacey Cooper is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacey Cooper was last updated on July 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.