Individual provider Active NPI

Christopher John Kopeck, DNAP, CRNA

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
National Provider Identifier
1083225296
Registry record updated May 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
24166 Issued in SC
Practice address
2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone
(843) 402-1436
NPI assigned
Aug 11, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 24166 SC Primary

Addresses

Primary practice location

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733

Mailing address

PO Box 603484
Charlotte, NC 28260-3484
Phone (803) 765-1838

Other identifiers 1

IdentifierTypeStateIssuer
AN3305MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201217002389 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961814850 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Gastroenterology SpecialistsGroup PAC ID 3173437472, 49 clinicians
Bon Secours St Francis Xavier Hospital IncGroup PAC ID 8325008717, 202 clinicians

Practice addresses (Care Compare)

1962 Charlie Hall Blvd
Charleston, SC 29414-5837
Phone (843) 722-8000

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1436

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24166SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Gastroenterology Specialists CurrentSince Nov 1, 2023 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. Current Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2020 Accepting new patients
Charleston Gastroenterology Specialists Current Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Oct 1, 2020 Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

1962 Charlie Hall Blvd
Charleston, SC 29414
Phone (803) 722-8000

2001 2nd Ave
Ste 101
Summerville, SC 29486
Phone (843) 722-8000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716076800000",
    "number": "1083225296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603484",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603484",
            "telephone_number": "803-765-1838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145733",
            "telephone_number": "843-402-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPECK",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "credential": "DNAP, CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-11",
        "last_updated": "2024-05-19",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "24166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN3305",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.