TYSON TRYON COPELAND – Registered Dietitian, NPI 1194569830

TYSON TRYON COPELAND is a healthcare provider. based in Libertyville, Illinois. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold a License No. 86118219 (IL). The NPI Number for TYSON TRYON COPELAND is 1194569830

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
TYSON TRYON COPELAND
NPI
1194569830
Phone
(224) 304-6606
Address
14344 SPRING MEADOW CT
Enumeration Date
19 June 2024
Last Update Date
19 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3128503438
Graduation Year
2023 (3 years ago)
PAC ID
7810428547
Group Practice PAC ID
8729118674
Professional Enrollment ID
I20241004000828
Address ID
IL606122345CH2003XSTXX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

311 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in IL

Provider Addresses for TYSON TRYON COPELAND

  • 14344 SPRING MEADOW CT

    LIBERTYVILLE, IL 600482490

    Phone: (224) 304-6606

    Type: Mailing

  • 2003 W FULTON ST STE 300

    CHICAGO, IL 606122345

    Phone: (312) 850-3438

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241004000828IRegistered Dietitian Or Nutrition ProfessionalILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60048)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8729118674View full group profile
NameSpecialtyState
-IL
-IL
Registered Dietitian Or Nutrition ProfessionalIL
-IL
-FL
-IL
-IL
-IL
-IL
Registered Dietitian Or Nutrition ProfessionalIL

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Frequently asked questions

What NPI should I save for TYSON TRYON COPELAND?
Save NPI 1194569830 if you need a stable reference for TYSON TRYON COPELAND.
Is TYSON TRYON COPELAND's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize TYSON TRYON COPELAND's specialty in plain language?
Clinically, the directory lists TYSON TRYON COPELAND with Registered Dietitian. Clinical services aligned with this taxonomy classification.
What location metadata exists for TYSON TRYON COPELAND?
The page summarizes Libertyville, Illinois for TYSON TRYON COPELAND; expand the address list for detail.
What if Libertyville, Illinois seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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