Copper Basin Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

COPPER BASIN SURGERY CENTER LLC

Practice address

3035 E Palmer Wasilla Hwy Ste 501
Wasilla, AK 99654-7274

Phone

(907) 357-5300

NPI assigned

Jan 30, 2023

Organization subpart

No

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

Authorized official

Name

Glinda Smith

Title

Business Development Director

Phone

(907) 301-4409

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Listed as

Copper Basin Surgery Center LLCCCN 02C0001022

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen D Markewich, MD

  • Pain Medicine Physician
  • Wasilla, AK
  • NPI 1295959823
  NPD
• Andrew Koogler, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Lakewood, WA
  • NPI 1851719421
  NPD (past)

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1619683968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 E PALMER WASILLA HWY STE 501",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547274",
            "telephone_number": "907-357-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 E PALMER WASILLA HWY STE 501",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547274",
            "telephone_number": "907-357-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER BASIN SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GLINDA",
        "authorized_official_title_or_position": "BUSINESS DEVELOPMENT DIRECTOR",
        "authorized_official_telephone_number": "907-301-4409"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Cooper
• Genece Cooper
• Jesse Faye Cooper, FNP-C
• Virginia Carol Cooper, PA-C
• Coordinated Care Planning
• Nicholas Corbin
• Christina Cordell
• Greggory Cordell
• Mason Cordell
• Haylee Corder

• Ambulatory Surgical Clinic/Center in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Ambulatory Surgical Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.