Copper Star Medical Supply

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

COPPER STAR MEDICAL SUPPLY

Practice address

2415 W Erie Dr
Tempe, AZ 85282-3112

Phone

(623) 303-9548

NPI assigned

Aug 12, 2022

Last updated

Aug 12, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

COPPER STAR MEDICAL SUPPLYAs reported in NPPES

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

Authorized official

Name

Sherry A Mildenberger, RT

Title

Director of Clinical Services

Phone

(801) 590-2714

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Copper Star Medical Supply

  • Oxygen Equipment & Supplies (DME)
  • Surprise, AZ
  • NPI 1124741335

  3678932191

  Same PAC ID
• Copper Star Medical Supply

  • Oxygen Equipment & Supplies (DME)
  • Phoenix, AZ
  • NPI 1508589714

  3678932191

  Same PAC ID
• Copper Star Medical Supply

  • Oxygen Equipment & Supplies (DME)
  • Mesa, AZ
  • NPI 1609599802

  3678932191

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Copper Star Medical Supply4 organizations share this tax ID, including this one

Part of

Copper Star Medical Supply

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Copper Star Medical Supply

  • Oxygen Equipment & Supplies (DME)
  • Surprise, AZ
  • NPI 1124741335
  NPD tax ID
• Copper Star Medical Supply

  • Oxygen Equipment & Supplies (DME)
  • Phoenix, AZ
  • NPI 1508589714
  NPD tax ID
• Copper Star Medical Supply

  • Oxygen Equipment & Supplies (DME)
  • Mesa, AZ
  • NPI 1609599802
  NPD tax ID

Locations

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1376271627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E 13065 S STE 200",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205646",
            "telephone_number": "801-590-2714",
            "fax_number": "801-463-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 W ERIE DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852823112",
            "telephone_number": "623-303-9548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 S Power Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852063716",
            "country_code": "US",
            "telephone_number": "602-960-4393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14175 W Indian School Rd Ste 8",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853958407",
            "country_code": "US",
            "telephone_number": "623-303-7724",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4030 E Bell Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850322150",
            "country_code": "US",
            "telephone_number": "602-833-7586",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13980 W Bell Rd Ste 19",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853743809",
            "country_code": "US",
            "telephone_number": "623-233-0268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COPPER STAR MEDICAL SUPPLY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COPPER STAR MEDICAL SUPPLY",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "MILDENBERGER",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "801-590-2714",
        "authorized_official_credential": "RT"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Nicholas Coon, ND
• Deborah A Cooney, C.N.P.
• Dakota Lana Cooper, DTR
• Kerry Cooper, M.D.
• Lori J Cooper, APRN
• Coraesthetics PLLC
• Andrew Corbett
• Jennifer Alia Corbett, M. ED.
• Margaret Corbett, LAT, ATC
• Tammera Lynn Cord-Gregory, FNP

• Oxygen Equipment & Supplies (DME) in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Oxygen Equipment & Supplies (DME) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.