Copper State Medical Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

COPPER STATE MEDICAL CENTER

Practice address

5556 S Integrity LN
Fort Mohave, AZ 86426-8861

Phone

(928) 514-3722

NPI assigned

Mar 25, 2024

Last updated

Mar 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Caroline Strecker, FNP-BCNPI 1043998628

Title

Provider

Phone

(928) 514-3722

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Caroline Chung Strecker, FNP-BC

  • Nurse Practitioner
  • Mohave Valley, AZ
  • NPI 1043998628
  NPD Authorized official

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1487404570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5556 S INTEGRITY LN",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864268861",
            "telephone_number": "928-514-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5556 S INTEGRITY LN",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864268861",
            "telephone_number": "928-514-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER STATE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "STRECKER",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "928-514-3722",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vicky Renee Conder-Elliott, RD
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• Corinne N Depriest, LMT
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• Keegan Michael Drawe, APRN
• Scott Duong, M.D.

• Primary Care Clinic/Center in Fort Mohave, AZ
• Providers in Fort Mohave, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.