Individual provider Active NPI

Alicia Marie Coppedge, RN

  • Registered Nurse
  • Bettendorf, IA
National Provider Identifier
1407552243
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
172924 Issued in IA
Practice address
4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone
(563) 742-5000
NPI assigned
Feb 2, 2023
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 172924 IA Primary

Addresses

Primary practice location

4500 Utica Ridge Rd
Bettendorf, IA 52722-1626

Mailing address

1202 N Stark St
Davenport, IA 52804-4224
Phone (907) 371-0993

Other names 1

  • Alicia Marie Coppedge Former name

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
172924IAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1407552243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 N STARK ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528044224",
            "telephone_number": "907-371-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 UTICA RIDGE RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221626",
            "telephone_number": "563-742-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPEDGE",
        "first_name": "ALICIA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "172924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "COPPEDGE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.