Individual provider Active NPI

Chanda Latrease Copeland, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1477820769
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN65807 Issued in DC
Practice address
1500 Galen St SE
Washington, DC 20020-4936
Phone
(202) 610-7160
Fax
(202) 610-7164
NPI assigned
Nov 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN65807 DC Primary
Family Nurse Practitioner 363LF0000X R136290 MD

Addresses

Primary practice location

1500 Galen St SE
Washington, DC 20020-4936

Mailing address

1220 12TH St SE
Suite 120
Washington, DC 20003-3722
Phone (202) 715-7900

Other identifiers 1

IdentifierTypeStateIssuer
024905300MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120301000727 DC Practitioner - Nurse Practitioner 2365601879 Reassigns benefits to 2 organizations
I20171114000982 MD Practitioner - Nurse Practitioner 2365601879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Maryland PCGroup PAC ID 9931489804, 43 clinicians

Practice addresses (Care Compare)

101 Centennial St
Suite H
La Plata, MD 20646-5976
Phone (301) 292-6010

11701 Livingston Rd
Suite 302
Ft Washington, MD 20744-5146
Phone (301) 292-6010

Merit-based Incentive Payment System (MIPS)

Final score
83.97 of 100Reported as group
Quality
78.47
Promoting interoperability
83
Improvement activities
40
Cost
82.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Health Care Inc. CurrentSince Jan 18, 2012 Accepting new patients
Advanced Dermatology of Maryland PC CurrentSince Jun 15, 2019 Accepting new patients
Advanced Dermatology of Maryland PC CurrentSince Jun 15, 2019 Accepting new patients
Unity Health Care, Inc. CurrentSince Jan 18, 2012 Accepting new patients

Locations

1500 Galen St SE
Washington, DC 20020
Phone (202) 610-7160

1310 Southern Ave SE
Washington, DC 20032
Phone (202) 574-6000

11701 Livingston Rd
Ste 302
Ft Washington, MD 20744
Phone (301) 292-6010

101 Centennial St
Ste H
La Plata, MD 20646
Phone (301) 292-6010

2401 Research Blvd
Ste 260
Rockville, MD 20850
Phone (301) 990-6565

7505 Osler Dr
Ste 308
Towson, MD 21204
Phone (410) 296-1464

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1477820769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 12TH ST SE",
            "address_2": "SUITE 120",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200033722",
            "telephone_number": "202-715-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 GALEN ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200204936",
            "telephone_number": "202-610-7160",
            "fax_number": "202-610-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "CHANDA",
        "middle_name": "LATREASE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN65807",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R136290",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024905300",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.