Copper Communities Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

HSPC5322 Issued in AZ

Legal business name

COPPER COMMUNITIES HOSPICE, LLC

Doing business as

Aviant Hospice Phoenix

Practice address

1400 N Gilbert Rd Ste H
Gilbert, AZ 85234-2321

Phone

(480) 398-2411

Fax

(480) 664-7071

NPI assigned

Oct 12, 2009

Last updated

May 16, 2022By 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

Richard E Bass

Title

President

Phone

(602) 717-4751

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Aviant Hospice Phoenix Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992030779. Details of each certification follow.

• CCN 031591 Hospice · Active · Details

Hospice certification: CCN 031591

Legal name

COPPER COMMUNITIES HOSPICE LLC

Doing business as

AVIANT HOSPICE PHOENIX

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 20, 2010

Last certification

Jun 8, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Aug 12, 2009 in AZ

Enrollment address

1400 N Gilbert Rd
Ste H
Gilbert, AZ 85234-2321

Listed as

Aviant Hospice PhoenixCCN 031591 · All quality measures

Ownership

For-Profit

Certified

Aug 20, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Roopesh K Kantala, M.D.

  • Medical Oncology Physician
  • Mesa, AZ
  • NPI 1811922198

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Kimberly Dawn Lee, APRN

  • Family Nurse Practitioner
  • Mesa, AZ
  • NPI 1104502590

  Hospice

  Care Compare affiliation
• Emily Miller, NP

  • Adult Health Nurse Practitioner
  • Tempe, AZ
  • NPI 1396158408

  Hospice

  Care Compare affiliation
• Alejandro Pineda, MD

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1508246398

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1992030779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 W RAY RD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243552",
            "telephone_number": "480-383-8599",
            "fax_number": "480-398-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N GILBERT RD STE H",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342321",
            "telephone_number": "480-398-2411",
            "fax_number": "480-664-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER COMMUNITIES HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-12",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-717-4751"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AZ",
            "license": "HSPC4796",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AZ",
            "license": "HSPC5322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "583314",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aviant Hospice Phoenix",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aviant Hospice Phoenix",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sondra L Cooper, RN
• Bryan Coots
• Spencer Garrett Copeland
• Casandra Coplan
• Copper Basin Oral Surgery
• Copper Springs Hospital, LLC (Copper Springs East)
• Copper State Dentistry LLC
• Copper Valley Health, LLC (Copper Valley Health)
• Elaina Corbin, OTR/L
• George M Corcoran, MD

• Community Based Hospice Care Agency in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Community Based Hospice Care Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.