Individual provider Active NPI

Candace Lynn Koopman, APRN

  • Nurse Practitioner
  • Florence, KY
National Provider Identifier
1083022529
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3011668 Issued in KY
Practice address
7370 Turfway Rd
Florence, KY 41042-4895
Phone
(859) 212-5125
Fax
(859) 212-5099
NPI assigned
Jul 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN.345067 OH
Nurse Practitioner 363L00000X 3011668 KY Primary

Addresses

Primary practice location

7370 Turfway Rd
Florence, KY 41042-4895

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 212-5125

Other identifiers 1

IdentifierTypeStateIssuer
0112132MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171031002906 KY Practitioner - Nurse Practitioner 5991923096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

7370 Turfway Rd
Florence, KY 41042-4895
Phone (859) 212-5125

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.345067OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Oct 30, 2017 Accepting new patients
Summit Medical Group, Inc Nurse Practitioner CurrentSince Oct 30, 2017 Accepting new patients

Locations

20 Medical Village Dr
Edgewood, KY 41017
Phone (859) 344-1600

7370 Turfway Rd
Florence, KY 41042
Phone (859) 212-5125

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

2626 Alexandria Pike
Highland Heights, KY 41076
Phone (859) 757-0434

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: ckoopman209559@direct-prd.stelizabeth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1083022529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-212-5125",
            "fax_number": "859-212-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7370 TURFWAY RD",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424895",
            "telephone_number": "859-212-5125",
            "fax_number": "859-212-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOPMAN",
        "first_name": "CANDACE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-29",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "RN.345067",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3011668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112132",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.