Individual provider Active NPI

Jeffrey C Coppersmith, P.T.

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1467594531
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00003173 Issued in WA
Practice address
5025 25TH Ave NE
Suite 201
Seattle, WA 98105-4151
Phone
(206) 524-6702
Fax
(206) 524-6703
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00003173 WA Primary

Addresses

Primary practice location

5025 25TH Ave NE
Suite 201
Seattle, WA 98105-4151

Mailing address

611 N 64TH St
Seattle, WA 98103-5631
Phone (206) 789-2951

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

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467594531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N 64TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981035631",
            "telephone_number": "206-789-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 25TH AVE NE",
            "address_2": "SUITE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054151",
            "telephone_number": "206-524-6702",
            "fax_number": "206-524-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPERSMITH",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00003173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.