Individual provider Active NPI

Curtis Kopotic, ATC

  • Athletic Trainer
  • Big Lake, MN
National Provider Identifier
1114374683
Registry record updated May 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2664 Issued in MN
Practice address
17094 Lupine LN
Big Lake, MN 55309-4646
Phone
(619) 955-9249
NPI assigned
May 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2664 MN Primary

Addresses

Primary practice location

17094 Lupine LN
Big Lake, MN 55309-4646

Mailing address

17094 Lupine LN
Big Lake, MN 55309-4646
Phone (619) 955-9249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2664MNMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1463270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463270400000",
    "number": "1114374683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17094 LUPINE LN",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553094646",
            "telephone_number": "619-955-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17094 LUPINE LN",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553094646",
            "telephone_number": "619-955-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPOTIC",
        "first_name": "CURTIS",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-15",
        "last_updated": "2016-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.