Individual provider Active NPI

Brian David Cooprider, IDMT

  • Independent Duty Medical Technicians
  • Bellevue, NE
National Provider Identifier
1790912608
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty Medical TechniciansTaxonomy code 1710I1003X
Practice address
2501 Capehart Road
Bellevue, NE 68113-2160
Phone
(402) 294-7333
NPI assigned
Jun 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Medical Technicians 1710I1003X Primary

Addresses

Primary practice location

2501 Capehart Road
Bellevue, NE 68113-2160

Mailing address

2501 Capehart Road
Apo, AP 68113-2160
Phone (402) 294-7333

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

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1790912608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "2501 CAPEHART ROAD",
            "city": "APO",
            "state": "AP",
            "postal_code": "681132160",
            "telephone_number": "402-294-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART ROAD",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681132160",
            "telephone_number": "402-294-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPRIDER",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.