Individual provider Active NPI

Rachel A Koeper, NP

  • Acute Care Nurse Practitioner
  • Appleton, WI
National Provider Identifier
1174581862
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2143-033 Issued in WI
Practice address
820 E Grant St
Appleton, WI 54911-3483
Phone
(920) 731-4138
NPI assigned
May 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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
Acute Care Nurse Practitioner 363LA2100X 2143-033 WI Primary

Addresses

Primary practice location

820 E Grant St
Appleton, WI 54911-3483

Mailing address

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 735-4645

Other identifiers 1

IdentifierTypeStateIssuer
43987800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091109000567 WI Practitioner - Nurse Practitioner 3870631088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Valley Nephrology Partners S CGroup PAC ID 3870559404, 12 clinicians

Practice addresses (Care Compare)

300 N Commercial St
Suite 200
Neenah, WI 54956-2619
Phone (920) 886-0818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Nephrology Partners S C CurrentSince Jan 14, 2017 Accepting new patients
Vitality Me Past Accepting new patients

Locations

300 N Commercial St
#200
Neenah, WI 54956
Phone (920) 886-0818

300 N Commercial St
Ste 2
Neenah, WI 54956
Phone (920) 886-0818

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174581862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 N MEADE ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113454",
            "telephone_number": "920-735-4645",
            "fax_number": "920-735-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E GRANT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113483",
            "telephone_number": "920-731-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPER",
        "first_name": "RACHEL",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WI",
            "license": "2143-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43987800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.