Active NPI
Kimberly H. Copeland, MD
- Pediatrics Physician
- Vancouver, WA
National Provider Identifier
1114948668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD00044472
- Practice address
- 2121 NE 139TH St
Suite 200
Vancouver, WA 98686-2316 - Phone
- (360) 487-1777
- Fax
- (360) 487-1779
- NPI assigned
- Jul 21, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Emergency Medicine) Physician | 207PP0204X | MD21409 | OR | |
| Pediatrics Physician | 208000000X | MD00044472 | WA | Primary |
Addresses
Primary practice location
2121 NE 139TH St
Suite 200
Vancouver, WA 98686-2316
Mailing address
PO Box 2077
Portland, OR 97208-2077
Phone (503) 413-3900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD00044472 | Other | WA | WA STATE LICENSE |
| PENDING | Medicaid | WA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD21409 | OR | MD | Pediatric Emergency Medicine (Emergency Medicine) Physician |
Interoperability endpoints
- kcopeland10834@direct.lhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318377600000",
"number": "1114948668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2077",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972082077",
"telephone_number": "503-413-3900",
"fax_number": "503-413-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 NE 139TH ST",
"address_2": "SUITE 200",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986862316",
"telephone_number": "360-487-1777",
"fax_number": "360-487-1779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPELAND",
"first_name": "KIMBERLY",
"middle_name": "H.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-21",
"last_updated": "2011-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "207PP0204X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Pediatric Emergency Medicine",
"state": "OR",
"license": "MD21409",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD00044472",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA STATE LICENSE",
"identifier": "MD00044472",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.