Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacey Cooper

Individual provider Medical Physician Assistant · NPI 1689486458

Jacey Cooper is a Physician Assistant in Williamsburg, Kentucky. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Kentucky and Tennessee.

Years since qualifying
1
Licensed in
KY, TN
In the registry since
2025
Specialties on file
2

Practice location Address checks out

475 N Highway 25 W Ste 100
Williamsburg, KY 40769-1576
Phone: (606) 549-2930
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA3827 (KY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 7082 (TN)

Record details

NPI number1689486458
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 21, 2025
Last updated in NPPESJuly 20, 2026
Certification dateJuly 20, 2026
Mailing addressPo Box 247, Jellico, TN 37762-0247

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Williamsburg