Amy M. Koepke, APNP
Individual provider Active NPI Family Nurse Practitioner · Woodruff, WI
NPI 1134479421 · NPPES record last updated Feb 5, 2021
Key facts
- NPI
- 1134479421
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5026-33 (WI)
- Practice address
- 240 Maple St
Woodruff, WI 54568-9190 - Phone
- (715) 356-8920
- NPI assigned
- Sep 13, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Park Nicollet Clinic
Westfields Hospital Inc
Practice addresses (Care Compare)
3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123
3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123
5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400
535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600
Hospital & facility affiliations
- Westfields Hospital and Clinic
- Amery Hospital & Clinic
- Park Nicollet Methodist Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI, MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120927000468 | WI | Practitioner - Nurse Practitioner | 5496904948 | Reassigns benefits to 2 organizations |
| I20250610000934 | MN | Practitioner - Nurse Practitioner | 5496904948 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5026-33 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amery Regional Medical Center, Inc. | Current |
Accepting new patients | |
| Westfields Hospital, Inc | Current |
Accepting new patients | |
| Park Nicollet Clinic | Current |
Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| Westfields Hospital, Inc. | Current |
Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current |
Accepting new patients | |
| Group Health, Inc. | Past | Accepting new patients |
Locations
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301
535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013
Interoperability endpoints
- akoepke229849@direct.healthpartners.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5026-33 | WI | Yes |
Addresses
Primary practice location
240 Maple St
Woodruff, WI 54568-9190
Mailing address
240 Maple St
Woodruff, WI 54568-9190
Phone (715) 356-8920
Other practice location 1
535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | amy.lavin.1@10114.direct.athenahealth.com |
Other providers in Woodruff, WI
- Cassie Elizabeth Kleinhans
- Brook Kmiecik
- Frederick Knoch
- Shirlee Ann Knox
- Taylor Grace Koehnen
- David W Koski
- Carla M Krembs
- Nancy Krings
- Kevin R Krueger
- Sara Emily Kulton
All providers in Woodruff, WI · Family Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.