Individual provider Active NPI

Jeffrey Francis Kopecky, CRNA

  • Certified Registered Nurse Anesthetist
  • Hood River, OR
National Provider Identifier
1124176649
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
88006334 Issued in OR
Practice address
811 13TH St
Hood River, OR 97031-1204
Phone
(541) 387-6330
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 88006334 OR Primary

Addresses

Primary practice location

811 13TH St
Hood River, OR 97031-1204

Mailing address

576 Rocky Rd
Hood River, OR 97031-9731
Phone (541) 387-6330

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
88006334ORMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124176649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 ROCKY RD",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970319731",
            "telephone_number": "541-387-6330",
            "fax_number": "541-387-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 13TH ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311204",
            "telephone_number": "541-387-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPECKY",
        "first_name": "JEFFREY",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "88006334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hood River, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.