Active NPI
Breah Shea Copeland, DPT
- Physical Therapist
- Tulsa, OK
National Provider Identifier
1992075691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4317
- Practice address
- 6585 S Yale Ave Ste 310
Tulsa, OK 74136-8334 - Phone
- (918) 502-4700
- Fax
- (918) 502-4701
- NPI assigned
- Jan 11, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4317 | OK | Primary |
Addresses
Primary practice location
6585 S Yale Ave Ste 310
Tulsa, OK 74136-8334
Mailing address
2488 E 81St St Ste 290
Tulsa, OK 74137-4265
Phone (918) 927-3737
Other practice location 1
12800 S Memorial Dr Ste D
Bixby, OK 74008-2577
Phone (918) 394-2770
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200413200A | Medicaid | OK |
Other names 1
- Breah Shea Nicolet
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4317 | OK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rheumatology & Osteoporosis Institute of Oklahoma LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rheumatology Physician
- Tulsa, OK
- NPI 1558716480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605830400000",
"number": "1992075691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2488 E 81ST ST STE 290",
"city": "TULSA",
"state": "OK",
"postal_code": "741374265",
"telephone_number": "918-927-3737",
"fax_number": "918-927-3193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6585 S YALE AVE STE 310",
"city": "TULSA",
"state": "OK",
"postal_code": "741368334",
"telephone_number": "918-502-4700",
"fax_number": "918-502-4701"
}
],
"practiceLocations": [
{
"address_1": "12800 S Memorial Dr Ste D",
"address_purpose": "LOCATION",
"city": "Bixby",
"state": "OK",
"postal_code": "740082577",
"country_code": "US",
"telephone_number": "918-394-2770",
"fax_number": "918-394-2772",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COPELAND",
"first_name": "BREAH",
"middle_name": "SHEA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-11",
"last_updated": "2020-11-20",
"certification_date": "2020-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "4317",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200413200A",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BREAH",
"last_name": "NICOLET",
"middle_name": "SHEA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.