Carly Rose Copenhaver, CFY-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2022036894 Issued in MO

Practice address

27600 E Colbern Rd
Lees Summit, MO 64086-8424

Phone

(816) 986-2330

NPI assigned

Oct 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lee'S Summit R-7 School District

  • Speech-Language Pathologist
  • Lees Summit, MO
  • NPI 1386936599
  NPD (past)

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1760109581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3602 NE AKIN DR UNIT B",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640643505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27600 E COLBERN RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640868424",
            "telephone_number": "816-986-2330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 NW Ward Rd",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640631849",
            "country_code": "US",
            "telephone_number": "816-986-1350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPENHAVER",
        "first_name": "CARLY",
        "middle_name": "ROSE",
        "credential": "CFY-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2022036894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.