Organization Active NPI

Coppes Chiropractic PC

  • Chiropractor
  • Burlington, IA
National Provider Identifier
1164550547
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
COPPES CHIROPRACTIC PC
Practice address
3115 Agency St
Burlington, IA 52601-1908
Phone
(319) 752-1460
Fax
(319) 752-1461
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Authorized official

Name
Dr. Ryan Andrew Coppes, D.C.NPI 1730319385
Title
President
Phone
(319) 752-1460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X IA Primary

Addresses

Primary practice location

3115 Agency St
Burlington, IA 52601-1908

Mailing address

3115 Agency St
Burlington, IA 52601-1908
Phone (319) 752-1460

Other identifiers 2

IdentifierTypeStateIssuer
DD6644OtherIARR MEDICARE
0462218MedicaidIA

Other names 1

  • Advance Chiropractic Center PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180227001497 IA Part B Supplier - Clinic/Group Practice 6406117878 Receives reassigned benefits from 4 practitioners
Practice locations: Burlington, IA

National Provider Directory

National Provider Directory

Locations

3115 Agency St
Burlington, IA 52601
Phone (319) 392-8567

Interoperability endpoints

  • Direct secure messaging: jpencedc@accp0004.direct.chirotouch.md
  • Direct secure messaging: estumpfdc@accp0004.direct.chirotouch.md

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513036800000",
    "number": "1164550547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 AGENCY ST",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526011908",
            "telephone_number": "319-752-1460",
            "fax_number": "319-752-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 AGENCY ST",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526011908",
            "telephone_number": "319-752-1460",
            "fax_number": "319-752-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPES CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2017-12-12",
        "status": "A",
        "authorized_official_last_name": "COPPES",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-752-1460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DD6644",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0462218",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advance Chiropractic Center PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlington, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.