Individual provider Active NPI

Haley Kopkau Janis, MD

  • Family Medicine Physician
  • Gaylord, MI
National Provider Identifier
1104305911
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4351050785 Issued in MI
Practice address
829 N Center Ave Ste 210
Gaylord, MI 49735-1599
Phone
(989) 731-7860
Fax
(989) 731-7833
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4351050785 MI Primary

Addresses

Primary practice location

829 N Center Ave Ste 210
Gaylord, MI 49735-1599

Mailing address

829 N Center Ave Ste 266
Gaylord, MI 49735-1595
Phone (989) 731-7860

Other names 1

  • Haley Kopkau Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Central Michigan College of Medicine, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2386

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4351050785MIMDFamily Medicine Physician

Hospital & facility affiliations 1

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": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1104305911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE STE 266",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351595",
            "telephone_number": "989-731-7860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE STE 210",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351599",
            "telephone_number": "989-731-7860",
            "fax_number": "989-731-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPKAU JANIS",
        "first_name": "HALEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351050785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "KOPKAU",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gaylord, MI

Sources for this page

Verify at the official NPI Registry.