Copper River Retirement Group, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COPPER RIVER RETIREMENT GROUP, LLC

Doing business as

Copper River Retirement Group

Practice address

272 W Everglade Ave
Clovis, CA 93619-3775

Phone

(559) 977-4232

NPI assigned

Oct 2, 2018

Last updated

Sep 25, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Costa

Title

Managing Member

Phone

(559) 977-4232

Specialties & licenses 1

Addresses

Other names 1

• Copper River Retirement Group Doing business as

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1871078295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27464",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937297464",
            "telephone_number": "559-977-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 W EVERGLADE AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936193775",
            "telephone_number": "559-977-4232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 E Pinehurst Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937305931",
            "country_code": "US",
            "telephone_number": "559-977-4232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "232 Omaha Ave",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936197617",
            "country_code": "US",
            "telephone_number": "559-977-4232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "419 W Loyola Ave",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936190439",
            "country_code": "US",
            "telephone_number": "559-977-4232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2617 E Shea Dr",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937204407",
            "country_code": "US",
            "telephone_number": "559-977-4232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COPPER RIVER RETIREMENT GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-02",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "559-977-4232"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Copper River Retirement Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela M. Cookingham, PT
• Gabrielle Coon
• Gregory Lee Copeland, DO
• Julius Lee Copeland Jr., MASSAGE THERAPIST
• Lee Roy Copeland, M.D.
• Marius Pablo Manansala Cordero, PHARMACIST
• Shannell M Cornealus
• Sarah Brown Cornelison, FNP-C
• Nikki Sarah Cornell, PT
• Karissa Corner

• Assisted Living Facility in Clovis, CA
• Providers in Clovis, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.