David W Koeper, MD
Individual provider Active NPI Nephrology Physician · Neenah, WI
NPI 1487698387 · NPPES record last updated Feb 10, 2012
Key facts
- NPI
- 1487698387
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 42143 (WI)
- Practice address
- 300 N Commercial St
Suite 200
Neenah, WI 54956-2619 - Phone
- (920) 886-0818
- Fax
- (920) 883-0773
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 25
Hospital & facility affiliations 26
Owned or controlled facilities with NPI records 23
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Loyola University of Chicago, Stritch School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fox Valley Nephrology Partners S C
St Vincent Hospital-Hospital Sisters-Third Order of St Francis
Practice addresses (Care Compare)
300 N Commercial St
Suite 200
Neenah, WI 54956-2619
Phone (920) 886-0818
670 Cormier Rd
Green Bay, WI 54304-4824
Phone (920) 494-9685
Hospital & facility affiliations
- FMC Dialysis - Appleton
- Fresenius Medical Care Oshkosh
- DaVita Green Lake County Dialysis
- Fresenius Kidney Care Sheboygan
- St Vincent Hospital
- Thedacare Regional Medical Center - Appleton Inc
- Ascension NE Wisconsin - St Elizabeth Campus
- Thedacare Regional Med Ctr - Neenah
- Thedacare Medical Center - Berlin Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 12
| Facility | Type | Role | Since |
|---|---|---|---|
| Thedacare Medical Center - Shawano, Inc. |
Hospital | Corporate Director | Feb 11, 2021 |
| Thedacare Medical Center - Shawano, Inc. |
Hospital | Corporate Director | Feb 11, 2021 |
| Thedacare Regional Medical Center-Neenah Inc |
Hospital | Corporate Director | Mar 1, 2022 |
| Thedacare Regional Medical Center - Appleton, Inc |
Hospital | Corporate Director | Jan 1, 2023 |
| Thedacare Medical Center - New London, Inc |
Hospital | Corporate Director | Jan 1, 2024 |
| Thedacare Medical Center - New London, Inc |
Hospital | Corporate Director | Jan 1, 2023 |
| Thedacare Regional Medical Center - Appleton, Inc |
Hospital | Corporate Director | Jan 1, 2021 |
| Peabody Manor |
Skilled nursing facility | Operational/Managerial Control | Jan 1, 2017 |
| Thedacare at Home |
Home health agency | Corporate Director | Jan 1, 2016 |
| Thedacare at Home |
Hospice | Corporate Officer | Jan 1, 2016 |
| Thedacare Medical Center - Shawano, Inc. |
Rural health clinic | Corporate Director | Feb 11, 2021 |
| Shawano Medical Center Inc |
Rural health clinic | Corporate Director | Feb 11, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040114000425 | WI | Practitioner - General Practice |
9234030206 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Nicholas Hospital-Sisters of the Third Order of St Francis | Current | Accepting new patients | |
| St Nicholas Hospital-Sisters of the Third Order of St Francis | Current |
Accepting new patients | |
| St Nicholas Hospital-Sisters of the Third Order of St Francis | Current |
Accepting new patients | |
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Current |
Accepting new patients | |
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Current |
Accepting new patients | |
| Montauk Dialysis LLC | Past |
Accepting new patients | |
| Thedacare, Incorporated | Past |
Accepting new patients | |
| Thedacare Medical Center - Shawano, Inc. | Past | Accepting new patients | |
| Fresenius Access Care Physicians of Madison LLC | Past |
Accepting new patients | |
| Fresenius Medical Care Green Bay Dialysis, LLC | Past |
Accepting new patients |
Locations
670 Cormier Rd
Green Bay, WI 54304
Phone (920) 494-9685
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710
Interoperability endpoints
- dkoeper7362@direct.thedacare.org
- dkoeper30462@ewd.direct.hshs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 42143 | WI | Yes |
Addresses
Primary practice location
300 N Commercial St
Suite 200
Neenah, WI 54956-2619
Mailing address
300 N Commercial St
Suite 200
Neenah, WI 54956-2619
Phone (920) 886-0818
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21280500 | Medicaid | WI | |
| 34168200 | Medicaid | WI |
Other providers in Neenah, WI
- Laurie A. Knutzen
- Brenda Kobin
- Barbara Ann Koch
- Tricia A Koch
- Michelle M. Koellermeier
- Elizabeth Ann Kohl
- Lynn B Kohlmeier
- Mia Kohls
- Lisa Mary Kokontis
- Scott C Kolbeck
All providers in Neenah, WI · Nephrology Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.