Peter Christopher Koepp, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-02309 Issued in NC

Practice address

2817 Reilly St
Fort Bragg, NC 28310-7324

Phone

(910) 396-7775

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkoepp@direct-searhc.org

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.

• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1154358232
  NPD
• Norton Sound Health Corporation

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Nome, AK
  • NPI 1427187046
  NPD
• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Excursion Inlet, AK
  • NPI 1063958452
  NPD
• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Juneau, AK
  • NPI 1427941343
  NPD
• Southeast Alaska Regional Health Consortium

  • Critical Access Hospital
  • Sitka, AK
  • NPI 1720062524
  NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1497867907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107324",
            "telephone_number": "910-396-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPP",
        "first_name": "PETER",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA05201",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8Y0987",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186438101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chong Ko, DPT
• Susan Oakes Koagel, DMD
• Mark Ross Kobialka, PA
• James L Koehler Jr., DMD
• Chad A Koenig
• Jordann Kokoski, DO
• Revati Komandur, MD
• John Komas
• Bradley Joseph Komrowski-Poppen, PHD
• John Victor Korby, FNP

• Medical Physician Assistant in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; 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.