Kimberly Dawn Kopetseg, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-1474 Issued in HI

Practice address

377 Keahole St
Honolulu, HI 96825-3405

Phone

(808) 395-4427

NPI assigned

May 31, 2012

Last updated

Jan 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1346501806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92-1545 ALIINUI DR # 3B",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072226",
            "telephone_number": "808-343-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 KEAHOLE ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968253405",
            "telephone_number": "808-395-4427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "86-260 Farrington Hwy",
            "address_purpose": "LOCATION",
            "city": "Waianae",
            "state": "HI",
            "postal_code": "967923128",
            "country_code": "US",
            "telephone_number": "808-696-7081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOPETSEG",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-1474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Arnold Kop, M.D.
• Donald M Kopf, PH.D.
• Kristi Koplin, FNP-C
• Carolyn Lei-Tina Kor, MD
• Priya Korathu-Larson, B.S.
• Korean Care Home

• Family Nurse Practitioner in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Family Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.