Healthcare Provider Details

I. General information

NPI: 1588583991
Provider Name (Legal Business Name): MR. CHANCE R COPELAND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WESTPORT RD
KANSAS CITY MO
64111-3145
US

IV. Provider business mailing address

800 WESTPORT RD
KANSAS CITY MO
64111-3145
US

V. Phone/Fax

Practice location:
  • Phone: 816-366-5515
  • Fax:
Mailing address:
  • Phone: 816-366-5515
  • Fax: 816-819-5873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: