Individual provider Active NPI

James Copeland

  • Adult Care Home Facility
  • Caldwell, ID
National Provider Identifier
1912798786
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
CFH-5972 Issued in ID
Practice address
16557 Spartan Ave
Caldwell, ID 83607-5224
Phone
(208) 353-1530
NPI assigned
May 13, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X CFH-5972 ID Primary

Addresses

Primary practice location

16557 Spartan Ave
Caldwell, ID 83607-5224

Mailing address

16557 Spartan Ave
Caldwell, ID 83607-5224
Phone (208) 353-1530

Other identifiers 1

IdentifierTypeStateIssuer
A0002760MedicaidID

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

State licenses

LicenseStateTypeSpecialty
CFH-5972IDMDAdult Care Home Facility

NPI Registry JSON

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1912798786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16557 SPARTAN AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836075224",
            "telephone_number": "208-353-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16557 SPARTAN AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836075224",
            "telephone_number": "208-353-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "ID",
            "license": "CFH-5972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A0002760",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.