Kelsey Copenhaver

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R54740 Issued in ND

Practice address

1200 Collins Ave
Mandan, ND 58554-2066

Phone

(701) 663-5373

NPI assigned

May 22, 2023

Last updated

Jul 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dakota Home Care, Inc.

  • Nursing Care Agency
  • Bismarck, ND
  • NPI 1780959809
  NPD (past)

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1033801816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 COLLINS AVE",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585542066",
            "telephone_number": "701-663-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 COLLINS AVE",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585542066",
            "telephone_number": "701-663-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPENHAVER",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R54740",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "ND",
            "license": "L17450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercede Christ
• Krista Christensen
• Rhonda Cloud
• Comfort Qualified Home Care LLC
• Amber Cook
• Dana Leann Cordova-Jacobson
• Monique Cordova
• Beth Ellen Cose
• Paige Cossette
• Bethany Cox

• Registered Nurse in Mandan, ND
• Providers in Mandan, ND by specialty
• Registered Nurse in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.