Individual provider Active NPI

Robert H. Copeland, CRNA

  • Certified Registered Nurse Anesthetist
  • Beaufort, SC
National Provider Identifier
1154380491
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2235 Issued in SC
Practice address
955 Ribaut Road
Beaufort, SC 29902
Phone
(803) 454-2613
Fax
(803) 765-1732
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2235 SC Primary

Addresses

Primary practice location

955 Ribaut Road
Beaufort, SC 29902

Mailing address

PO Box 1927
Columbia, SC 29202
Phone (803) 765-1838

Other identifiers 1

IdentifierTypeStateIssuer
AN0021MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040607000802 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385626886 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2235SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Low Country Anesthesia, PA CurrentSince Mar 1, 2017 Accepting new patients

Locations

955 Ribaut Rd
#11
Beaufort, SC 29902
Phone (843) 522-5007

955 Ribaut Rd
Ste 11
Beaufort, SC 29902
Phone (843) 522-5746

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1154380491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1927",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29202",
            "telephone_number": "803-765-1838",
            "fax_number": "803-765-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 RIBAUT ROAD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29902",
            "telephone_number": "803-454-2613",
            "fax_number": "803-765-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "ROBERT",
        "middle_name": "H.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "2235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN0021",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.