Individual provider Active NPI

Phillip Copper, M.D.

  • Anesthesiology Physician
  • Saint Louis, MO
National Provider Identifier
1760793699
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2010019207 Issued in MO
Practice address
600 S Euclid Ave # Cb8054
Saint Louis, MO 63110-1010
Phone
(314) 362-6978
Fax
(314) 747-4284
NPI assigned
Jun 25, 2010
Last updated
Jun 25, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2010019207 MO Primary

Addresses

Primary practice location

600 S Euclid Ave # Cb8054
Saint Louis, MO 63110-1010

Mailing address

600 S Euclid Ave # Cb8054
Saint Louis, MO 63110-1010
Phone (314) 362-6978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20150707001843 MO Practitioner - Anesthesiology 1153633060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Heart Anesthesiology LLCGroup PAC ID 8022042258, 4 clinicians

Practice addresses (Care Compare)

222 S Woods Mill Rd 550
Chesterfield, MO 63017-3625
Phone (314) 542-4798

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010019207MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Open Heart Anesthesiology, LLC Anesthesiology CurrentSince Jul 1, 2015 Accepting new patients
Cardiothoracic Surgery, LLC Past Accepting new patients

Locations

222 S Woods Mill Rd
Ste 550
Chesterfield, MO 63017
Phone (314) 434-3049

222 S Woods Mill Rd
Ste 550N
Chesterfield, MO 63017
Phone (314) 434-3049

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1760793699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S EUCLID AVE # CB8054",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-6978",
            "fax_number": "314-747-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S EUCLID AVE # CB8054",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-6978",
            "fax_number": "314-747-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPER",
        "first_name": "PHILLIP",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2010019207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.