Organization Active NPI

Copper Communities Hospice, LLC

  • Pain Medicine Physician
  • Mesa, AZ
National Provider Identifier
1205185170
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
COPPER COMMUNITIES HOSPICE, LLC
Doing business as
Copper Communities Palliative Care
Practice address
1640 S Stapley Dr
Ste. 245
Mesa, AZ 85204-6664
Phone
(480) 383-8599
NPI assigned
Sep 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Authorized official

Name
Richard E Bass
Title
Managing Partner
Phone
(602) 717-4751

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Pain Management Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0000X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

1640 S Stapley Dr
Ste. 245
Mesa, AZ 85204-6664

Mailing address

1640 S Stapley Dr
Ste. 245
Mesa, AZ 85204-6664
Phone (480) 383-8599

Other names 1

  • Copper Communities Palliative Care Doing business as

National Provider Directory

National Provider Directory

Locations

226 W Main St
Superior, AZ 85173
Phone (520) 391-3000

Practitioners & affiliated clinicians

Practitioners 1

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": "1346889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1205185170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 S STAPLEY DR",
            "address_2": "STE. 245",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046664",
            "telephone_number": "480-383-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 S STAPLEY DR",
            "address_2": "STE. 245",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046664",
            "telephone_number": "480-383-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER COMMUNITIES HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-06",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "602-717-4751"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Copper Communities Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.