Active NPI
Kathleen Kopach, M.D.
- Orthopaedic Surgery Physician
- Jacksonville, FL
National Provider Identifier
1205825171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- ME58668
- Practice address
- 655 W 8TH St
Ufjp Orthopedics
Jacksonville, FL 32209-6511 - Phone
- (904) 244-6224
- NPI assigned
- Oct 13, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | ME58668 | FL | Primary |
Addresses
Primary practice location
655 W 8TH St
Ufjp Orthopedics
Jacksonville, FL 32209-6511
Mailing address
PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000469807B | Medicaid | GA | |
| 0168527-00 | Medicaid | FL |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 989 | FL | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234828800000",
"number": "1205825171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 44008",
"address_2": "UFJP PROVIDER ENROLLMENT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322314008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 W 8TH ST",
"address_2": "UFJP ORTHOPEDICS",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322096511",
"telephone_number": "904-244-6224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPACH",
"first_name": "KATHLEEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-13",
"last_updated": "2009-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "FL",
"license": "ME58668",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000469807B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0168527-00",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.