Robert Koupal, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

00529 Issued in IA

Practice address

2102 E 38TH St
Davenport, IA 52807-1135

Phone

(563) 359-4049

Fax

(563) 359-4069

NPI assigned

Aug 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychology Health GroupGroup PAC ID 7810887452, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Psychology Health Group

  • Psychologist
  • Davenport, IA
  • NPI 1629090675
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1174516991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 E 38TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071135",
            "telephone_number": "563-359-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 E 38TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071135",
            "telephone_number": "563-359-4049",
            "fax_number": "563-359-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUPAL",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149006072",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "00529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS IOWA IL NUMBER",
            "identifier": "99862",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS IOWA IA NUMBER",
            "identifier": "34752",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH AND CCN NUMB",
            "identifier": "2216745",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0582221",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE NUMBER",
            "identifier": "IL0199",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ILLINOIS NUMBE",
            "identifier": "149006072",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1582221",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Andrew Kopf, RPH
• Lisa A Kopp, DO
• Steve G Kopp, PH.D.
• Samantha Koranda, PHARMD
• Nehemiah Sahr Koroma, BEHAVIOR ANALYST
• Valerie Lynn Koutny, RPH
• George Kovach, MD
• Yunus Kowi, D.C
• Kaelene Kragenbrink-Voorhees, ATC, LAT
• Michael R Kramer, AUDIOLOGIST

• Clinical Social Worker in Davenport, IA
• Providers in Davenport, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.