Active NPI
Jeremy Allen Koppus
- Addiction (Substance Use Disorder) Counselor
- Toledo, OH
National Provider Identifier
1447137708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.193099
- Practice address
- 4352 W Sylvania Ave Ste a
Toledo, OH 43623-3441 - Phone
- (419) 561-5433
- NPI assigned
- Aug 19, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.193099 | OH | Primary |
Addresses
Primary practice location
4352 W Sylvania Ave Ste a
Toledo, OH 43623-3441
Mailing address
4352 W Sylvania Ave Ste a
Toledo, OH 43623-3441
Phone (419) 561-5433
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.193099 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755561600000",
"number": "1447137708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4352 W SYLVANIA AVE STE A",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436233441",
"telephone_number": "419-561-5433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4352 W SYLVANIA AVE STE A",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436233441",
"telephone_number": "419-561-5433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPPUS",
"first_name": "JEREMY",
"middle_name": "ALLEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-08-19",
"last_updated": "2025-08-19",
"certification_date": "2025-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.193099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.