Individual provider Active NPI

Antonia Teodora Kopp, MD

  • Pediatrics Physician
  • West Chester, OH
National Provider Identifier
1407351000
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
57.246620 Issued in OH
Practice address
8752 Union Centre Blvd
West Chester, OH 45069-4876
Phone
(513) 682-5400
NPI assigned
Mar 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 57.246620 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

8752 Union Centre Blvd
West Chester, OH 45069-4876

Mailing address

8752 Union Centre Blvd
West Chester, OH 45069-4876
Phone (513) 682-5400

Other practice location 1

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230606001629 MA Practitioner - Pediatric Medicine 8921357179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Care Inc. Pediatrics PastSince Jul 17, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1407351000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8752 UNION CENTRE BLVD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450694876",
            "telephone_number": "513-682-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8752 UNION CENTRE BLVD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450694876",
            "telephone_number": "513-682-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "43205",
            "country_code": "US",
            "telephone_number": "614-722-4411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOPP",
        "first_name": "ANTONIA",
        "middle_name": "TEODORA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "57.246620",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

Verify at the official NPI Registry.