Tyson Tryon Copeland

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86118219 Issued in IL

Practice address

2003 W Fulton St Ste 300
Chicago, IL 60612-2345

Phone

(312) 850-3438

NPI assigned

Jun 19, 2024

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

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dietitians at Home Inc

  • Registered Dietitian
  • Chicago, IL
  • NPI 1215250568

  Dietitian, Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1194569830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14344 SPRING MEADOW CT",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482490",
            "telephone_number": "224-304-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 W FULTON ST STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122345",
            "telephone_number": "312-850-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "TYSON",
        "middle_name": "TRYON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "86118219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Copeland
• Mallory Copeland
• Maureen Copeland, D.D.S.
• Raphael Copeland, PTA
• Ross Graham Copeland, DPT
• Carlos E Copello, DMD
• Mario E Copello, DMD
• Copernicus Medical Corporation.,LTD.
• Copes Special Needs Services LLP
• Valerie Copits

• Registered Dietitian in Chicago, IL
• Providers in Chicago, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.