Active NPI
Blaine Lauren Coppaken, SLP
- Audiologist
- Overland Park, KS
National Provider Identifier
1063702256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 2975
- Practice address
- 5211 W 103Rd St
Overland Park, KS 66207-3154 - Phone
- (913) 383-2569
- Fax
- (913) 383-2611
- NPI assigned
- Apr 9, 2011
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 2975 | KS | Primary |
Addresses
Primary practice location
5211 W 103Rd St
Overland Park, KS 66207-3154
Mailing address
13149 Birch St
Overland Park, KS 66209-2917
Phone (913) 558-4148
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2975 | KS | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302307200000",
"number": "1063702256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13149 BIRCH ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662092917",
"telephone_number": "913-558-4148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5211 W 103RD ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662073154",
"telephone_number": "913-383-2569",
"fax_number": "913-383-2611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPPAKEN",
"first_name": "BLAINE",
"middle_name": "LAUREN",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-09",
"last_updated": "2011-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "KS",
"license": "2975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.