NPIMap

Individual provider Active NPI

David W Koeper, MD

  • Nephrology Physician
  • Neenah, WI
National Provider Identifier
1487698387
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
42143 Issued in 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
Last updated
Feb 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 42143 WI Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040114000425 WI Practitioner - General PracticePractitioner - Nephrology 9234030206 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Nephrology
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 CGroup PAC ID 3870559404, 12 clinicians

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Feb 1, 2020 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 CurrentSince Feb 1, 2020 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Feb 1, 2020 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Feb 1, 2020 Accepting new patients
Fresenius Medical Care Green Bay Dialysis, LLC PastSince Jan 14, 2022 Accepting new patients
Thedacare, Incorporated PastSince Jan 1, 2021 Accepting new patients
Montauk Dialysis LLC PastSince Dec 1, 2015 Accepting new patients
Thedacare Medical Center - Shawano, Inc. Past Accepting new patients
Fresenius Access Care Physicians of Madison LLC PastSince Mar 1, 2023 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

  • Direct secure messaging: dkoeper30462@ewd.direct.hshs.org
  • Direct secure messaging: dkoeper7362@direct.thedacare.org

Ownership & related parties

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Thedacare Medical Center - Shawano, Inc.Shawano, WI, CCN 521346 Hospital Corporate Director Feb 11, 2021
Thedacare Medical Center - Shawano, Inc.Shawano, WI, CCN 52Z346 Hospital Corporate Director Feb 11, 2021
Thedacare Regional Medical Center-Neenah IncNeenah, WI, CCN 520045 Hospital Corporate Director Mar 1, 2022
Thedacare Regional Medical Center - Appleton, IncAppleton, WI, CCN 520160 Hospital Corporate Director Jan 1, 2023
Thedacare Medical Center - New London, IncNew London, WI, CCN 521326 Hospital Corporate Director Jan 1, 2024
Thedacare Medical Center - New London, IncNew London, WI, CCN 52Z326 Hospital Corporate Director Jan 1, 2023
Thedacare Regional Medical Center - Appleton, IncAppleton, WI, CCN 52T160 Hospital Corporate Director Jan 1, 2021
Peabody ManorAppleton, WI, CCN 525548 Skilled nursing facility Operational/Managerial Control Jan 1, 2017
Thedacare at HomeAppleton, WI, CCN 527010 Home health agency Corporate Director Jan 1, 2016
Thedacare at HomeAppleton, WI, CCN 521504 Hospice Corporate Officer Jan 1, 2016
Thedacare Medical Center - Shawano, Inc.Shawano, WI, CCN 528614 Rural health clinic Corporate Director Feb 11, 2021
Shawano Medical Center IncClintonville, WI, CCN 528608 Rural health clinic Corporate Director Feb 11, 2021

Owned or controlled facilities with NPI records 23

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 23

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1487698387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N COMMERCIAL ST",
            "address_2": "SUITE 200",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562619",
            "telephone_number": "920-886-0818",
            "fax_number": "920-883-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N COMMERCIAL ST",
            "address_2": "SUITE 200",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562619",
            "telephone_number": "920-886-0818",
            "fax_number": "920-883-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPER",
        "first_name": "DAVID",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WI",
            "license": "42143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.