Individual provider Active NPI

Rose Copper-Brown, MNT

  • Renal Nutrition Registered Dietitian
  • Clifton Springs, NY
National Provider Identifier
1962606491
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
License
002873 Issued in NY
Practice address
2 Coulter Rd
Clifton Springs, NY 14432-1122
Phone
(315) 462-0269
NPI assigned
Jun 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X 002873 NY Primary

Addresses

Primary practice location

2 Coulter Rd
Clifton Springs, NY 14432-1122

Mailing address

PO Box 105
Clifton Springs, NY 14432-0105

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
002873NYMDArt Therapist

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962606491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 105",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144320105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COULTER RD",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321122",
            "telephone_number": "315-462-0269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPER-BROWN",
        "first_name": "ROSE",
        "credential": "MNT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "NY",
            "license": "002873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.