David Arlen Vancoppenolle, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070011282 Issued in IL

Practice address

2200 East Washington St.
Bloomington, IL 61701

Phone

(309) 662-3311

Fax

(309) 862-4754

NPI assigned

Aug 30, 2012

Last updated

Aug 30, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1447509872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 EAST WASHINGTON ST.",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61701",
            "telephone_number": "309-662-3311",
            "fax_number": "309-862-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 EAST WASHINGTON ST.",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61701",
            "telephone_number": "309-662-3311",
            "fax_number": "309-862-4754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCOPPENOLLE",
        "first_name": "DAVID",
        "middle_name": "ARLEN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-30",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070011282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ricardo Vallejo, MD
• Van Aman Center for Wellness, PLLC
• Tana Van Meter, PT,DPT
• Stacey Karzen Van Scoyoc, DDS
• Tracy L Vanapeldoorn, APRN, FNP-C
• William K. Vanderwaal, D.D.S.
• Jessica N Vanderway, M.S. CF-SLP
• Jesse L Vanle, M.D.
• John Peter Vanscoyoc, DDS
• Clara Varlese, LCPC,NCC

• Physical Therapist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.

Verify at the official NPI Registry.