Active NPI
Mary Ellen Copening, P.A
- Physician Assistant
- Lebanon, NH
National Provider Identifier
1215967914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0148
- Practice address
- 18 Old Etna Rd
DH - Internal Medicine
Lebanon, NH 03766 - Phone
- (603) 650-4000
- Fax
- (603) 650-4190
- NPI assigned
- Jul 5, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0148 | NH | Primary |
Addresses
Primary practice location
18 Old Etna Rd
DH - Internal Medicine
Lebanon, NH 03766
Mailing address
1 Medical Center Dr
DHMC - Gim
Lebanon, NH 03756-1000
Phone (603) 650-4000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0AP0777 | Medicaid | VT | |
| 30010001 | Medicaid | NH |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0148 | NH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brattleboro Memorial Hospital | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/
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.
-
- General Acute Care Hospital
- Brattleboro, VT
- NPI 1306849708
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356566400000",
"number": "1215967914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"address_2": "DHMC - GIM",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 OLD ETNA RD",
"address_2": "DH - INTERNAL MEDICINE",
"city": "LEBANON",
"state": "NH",
"postal_code": "03766",
"telephone_number": "603-650-4000",
"fax_number": "603-650-4190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPENING",
"first_name": "MARY ELLEN",
"name_prefix": "Mrs.",
"credential": "P.A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2012-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NH",
"license": "0148",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0AP0777",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30010001",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.