Individual provider Active NPI

Kelly Marie Copeland, FNP-C

  • Family Nurse Practitioner
  • Midlothian, TX
National Provider Identifier
1760940746
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140692 Issued in TX
Practice address
979 Don Floyd Dr Ste 124
Midlothian, TX 76065-6695
Phone
(972) 775-4132
Fax
(972) 775-4620
NPI assigned
Mar 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP140692 TX Primary

Addresses

Primary practice location

979 Don Floyd Dr Ste 124
Midlothian, TX 76065-6695

Mailing address

979 Don Floyd Dr Ste 124
Midlothian, TX 76065-6695
Phone (972) 775-4132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190903001993 TX Practitioner - Nurse Practitioner 4385973254 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kcopeland104476@dm.mhd.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1760940746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "979 DON FLOYD DR STE 124",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760656695",
            "telephone_number": "972-775-4132",
            "fax_number": "972-775-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 DON FLOYD DR STE 124",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760656695",
            "telephone_number": "972-775-4132",
            "fax_number": "972-775-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, TX

Sources for this page

Verify at the official NPI Registry.