Javonnia Copeland, NP
Individual provider Active NPI Family Nurse Practitioner · Lansing, MI
NPI 1992262802 · NPPES record last updated Feb 27, 2019
Key facts
- NPI
- 1992262802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704298542 (MI)
- Practice address
- 5303 S Cedar St
Lansing, MI 48911-3800 - Phone
- (517) 887-4303
- NPI assigned
- Feb 27, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211206001963 | AR | Practitioner - Nurse Practitioner | 4284024258 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704298542 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson Comprehensive Care System, Inc | Current | Accepting new patients | |
| Jefferson Comprehensive Care System, Inc | Current |
Accepting new patients | |
| Jefferson Comprehensive Care System, Inc | Current |
Accepting new patients |
Locations
1101 S Tennessee St
Pine Bluff, AR 71601
Phone (870) 543-2300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704298542 | MI | Yes |
Addresses
Primary practice location
5303 S Cedar St
Lansing, MI 48911-3800
Mailing address
PO Box 30161
Lansing, MI 48909-7661
Phone (517) 887-4303
Other providers in Lansing, MI
- Mackenzie A Cooper
- Patrick B Cooper
- Tina Cooper
- Tyler Samuel Cooper
- Alyssa Copeland
- Samantha Coppola
- Coram Alternate Site Services, Inc.
- Madeline Hulse Corbett
- Pamela Corden
- Elizabeth Corder
All providers in Lansing, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.