Copper Ridge Medical PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

G1494 Issued in TX

Legal business name

COPPER RIDGE MEDICAL PA

Practice address

7600 Highway 29 W
Ste #5
Georgetown, TX 78628-6937

Phone

(512) 930-0363

Fax

(512) 930-0371

NPI assigned

May 1, 2008

Organization subpart

No

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

Authorized official

Name

Ann Nolen, D.O.

Title

Owner

Phone

(512) 930-0363

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Carrie Novak Culpepper, RN, FNP-C

  • Family Nurse Practitioner
  • Fredericksburg, TX
  • NPI 1386696581
  NPD (past)

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1750557641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 HIGHWAY 29 W",
            "address_2": "STE #5",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786286937",
            "telephone_number": "512-930-0363",
            "fax_number": "512-930-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 HIGHWAY 29 W",
            "address_2": "STE #5",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786286937",
            "telephone_number": "512-930-0363",
            "fax_number": "512-930-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER RIDGE MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "NOLEN",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-930-0363",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "G1494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN STATE LICENSE",
            "identifier": "G1494",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Conscious Decisions Family Therapy Services, PLLC
• Sarah Elizabeth Edmiston Contrada, PT, DPT
• Rebecca Sansom Cook, PT
• Terry W Cook, LPC, NCC, MAC
• Kellsie Renae Coonce, PT, DPT
• Giavanna Coppola, PT, DPT
• Core Clarity Psychiatry & Behavioral Health PLLC
• William Christopher Cornman, D.D.S.
• William Corona, CRNA
• Tamara Leigh Corrales, LPC

• Clinic/Center in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.