Anna Marie Koopman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11529729-3501 Issued in UT

Practice address

478 N 60 W
Smithfield, UT 84335-1233

Phone

(208) 569-0166

NPI assigned

Oct 11, 2019

Sex

Female

Sole proprietor

No

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.

• Ora Counseling

  • Multi-Specialty Clinic/Center
  • Logan, UT
  • NPI 1043810047
  NPD
• Ora Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Logan, UT
  • NPI 1285447433
  NPD
• The Family Place Utah

  • Community/Behavioral Health Agency
  • Logan, UT
  • NPI 1326336447
  NPD (past)
• Medical Imaging Associates of Idaho Falls, Inc

  • Diagnostic Radiology Physician
  • Pocatello, ID
  • NPI 1740225531
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 13, 2024.

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1356983258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "879 S 250 E APT 93",
            "city": "SMITHFIELD",
            "state": "UT",
            "postal_code": "843354732",
            "telephone_number": "208-569-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 N 60 W",
            "city": "SMITHFIELD",
            "state": "UT",
            "postal_code": "843351233",
            "telephone_number": "208-569-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOPMAN",
        "first_name": "ANNA MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11529729-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Logan",
            "affiliation": "N",
            "address_1": "1525 N 200 W",
            "city": "Logan",
            "state": "UT",
            "country_code": "US",
            "postal_code": "843412032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ira J Crawford LLC
• Travis C Jackson, ATC-L
• Jonathan D Miles DDS, PC
• Racheal Killgore, LPCC
• Schon Thomas Knowles
• Larry'S Smithfield Pharmacy, Inc.
• Larrys Smithfield Pharmacy Inc
• Lees Marketplace Inc
• Jeffrey Madsen
• Pamela Major

• All providers in Smithfield, UT
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.