Individual provider Active NPI

John Copeland, D.O.

  • Military Health Care Provider
  • Whiteman AFB, MO
National Provider Identifier
1609204254
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Health Care ProviderTaxonomy code 171000000X
Practice address
331 Sijen Ave
Whiteman AFB, MO 65305-1269
Phone
(660) 687-2157
Fax
(660) 687-1148
NPI assigned
Oct 17, 2013
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X OS 12894 FL
Military Health Care Provider 171000000X NU Primary

Addresses

Primary practice location

331 Sijen Ave
Whiteman AFB, MO 65305-1269

Mailing address

331 Sijen Ave
Whiteman AFB, MO 65305-1269
Phone (660) 687-2157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170819000171 TX Order and Referring Only - General PracticePractitioner - General PracticePractitioner - Preventive Medicine 3779855168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS 12894FLMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1609204254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 SIJEN AVE",
            "city": "WHITEMAN AFB",
            "state": "MO",
            "postal_code": "653051269",
            "telephone_number": "660-687-2157",
            "fax_number": "660-687-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 SIJEN AVE",
            "city": "WHITEMAN AFB",
            "state": "MO",
            "postal_code": "653051269",
            "telephone_number": "660-687-2157",
            "fax_number": "660-687-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-17",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS 12894",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteman AFB, MO

Sources for this page

Verify at the official NPI Registry.