Active NPI
Bethany Dawn Coppock, COTA
- Occupational Therapy Assistant
- Marion, IN
National Provider Identifier
1063634699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 32001358A
- Practice address
- 4725 Colonial Oaks Drive
Marion, IN 46953 - Phone
- (765) 674-9791
- NPI assigned
- May 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 32001358A | IN | Primary |
Addresses
Primary practice location
4725 Colonial Oaks Drive
Marion, IN 46953
Mailing address
802 S Barclay St
Fairmount, IN 46928
Phone (765) 251-1531
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32001358A | IN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063634699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 S BARCLAY ST",
"city": "FAIRMOUNT",
"state": "IN",
"postal_code": "46928",
"telephone_number": "765-251-1531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4725 COLONIAL OAKS DRIVE",
"city": "MARION",
"state": "IN",
"postal_code": "46953",
"telephone_number": "765-674-9791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPPOCK",
"first_name": "BETHANY",
"middle_name": "DAWN",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IN",
"license": "32001358A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.