Individual provider Active NPI

Elizabeth S Copp, PAC

  • Physician Assistant
  • Brighton, MI
National Provider Identifier
1295913861
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003217 Issued in MI
Practice address
10415 Grand River Rd
Ste 100
Brighton, MI 48116-6533
Phone
(810) 227-1020
Fax
(810) 227-4930
NPI assigned
Feb 6, 2008
Last updated
Feb 6, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601003217 MI Primary

Addresses

Primary practice location

10415 Grand River Rd
Ste 100
Brighton, MI 48116-6533

Mailing address

10415 Grand River Rd
Ste 100
Brighton, MI 48116-6533
Phone (810) 227-1020

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

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1295913861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10415 GRAND RIVER RD",
            "address_2": "STE 100",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481166533",
            "telephone_number": "810-227-1020",
            "fax_number": "810-227-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10415 GRAND RIVER RD",
            "address_2": "STE 100",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481166533",
            "telephone_number": "810-227-1020",
            "fax_number": "810-227-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPP",
        "first_name": "ELIZABETH",
        "middle_name": "S",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.