Active NPI
Matt Copple, PHR
- In Home Supportive Care Agency
- Maple Valley, WA
National Provider Identifier
1639558778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- IHS.FS.60506716
- Practice address
- 26625 225TH Ave SE
Maple Valley, WA 98038-7448 - Phone
- (206) 948-5354
- NPI assigned
- May 21, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | IHS.FS.60506716 | WA | Primary |
Addresses
Primary practice location
26625 225TH Ave SE
Maple Valley, WA 98038-7448
Mailing address
PO Box 43
Maple Valley, WA 98038-0043
Phone (425) 358-4644
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IHS.FS.60606716 | Other | WA | DEPARTMENT OF HEALTH |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IHS.FS.60506716 | WA | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432166400000",
"number": "1639558778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 43",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980380043",
"telephone_number": "425-358-4644",
"fax_number": "425-947-9844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26625 225TH AVE SE",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980387448",
"telephone_number": "206-948-5354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPPLE",
"first_name": "MATT",
"credential": "PHR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-21",
"last_updated": "2015-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "WA",
"license": "IHS.FS.60506716",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF HEALTH",
"identifier": "IHS.FS.60606716",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maple Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.