Dennis Copenhaver, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01826 Issued in TX

Practice address

4504 Boat Club Rd
Suite 800
Fort Worth, TX 76135-7003

Phone

(817) 237-0515

Fax

(817) 237-8982

NPI assigned

Aug 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114035375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4504 BOAT CLUB RD",
            "address_2": "SUITE 800",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357003",
            "telephone_number": "817-237-0515",
            "fax_number": "817-237-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4504 BOAT CLUB RD",
            "address_2": "SUITE 800",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357003",
            "telephone_number": "817-237-0515",
            "fax_number": "817-237-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPENHAVER",
        "first_name": "DENNIS",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macullen Cope, PHARMD
• Ericka Yafaye Copeland-Malone
• Jennifer Lynn Copeland, BSN, RN, CCRN
• Jessica Copeland, NBC-HWC
• Keesha Copeland, APRN, A-GNP-C
• Coppell Spine & Sports Rehab Limited Partnership
• Coppell Spine & Sports Rehab Limited Partnership
• Coppell Spine & Sports Rehab Limited Partnership
• Coppell Spine & Sports Rehab Limted Partnership
• Coram Healthcare Corporation of North Texas

• All providers in Fort Worth, TX
• Physician Assistant in Texas

• 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.

Verify at the official NPI Registry.