Individual provider Active NPI

Marni Kopenski Hebert, F.N.P.

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1568406346
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2040-033 Issued in WI
Practice address
2906 S 20TH St
Milwaukee, WI 53215-3732
Phone
(414) 672-1353
Fax
(414) 672-4265
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2040-033 WI Primary

Addresses

Primary practice location

2906 S 20TH St
Milwaukee, WI 53215-3732

Mailing address

2906 S 20TH St
Milwaukee, WI 53215-3732
Phone (414) 672-1353

Other identifiers 1

IdentifierTypeStateIssuer
43969700MedicaidWI

Other names 1

  • Marni Lynne Kopenski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040701000725 WI Practitioner - Nurse Practitioner 8325025901 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2040WIMDRegistered Dietitian
2040-033WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
16TH Street Community Health Center Inc. Current Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Jul 20, 2015 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Aurora Quick Care, LLC PastSince Jun 28, 2017 Accepting new patients
Sixteenth Street Community Health Centers, Inc. Past Accepting new patients
Commonwealth Medical Group, LLC Past Accepting new patients
Deborah Luetzow-Franson M.D., S.C. Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

7400 W Rawson Ave
Ste 142
Franklin, WI 53132
Phone (414) 427-0008

6080 S 108th St
Hales Corners, WI 53130
Phone (414) 282-5314

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204

4570 S 27th St
Milwaukee, WI 53221
Phone (414) 325-8720

2745 W Layton Ave
Ste 206
Milwaukee, WI 53221
Phone (414) 281-9665

1635 W National Ave
Milwaukee, WI 53204
Phone (262) 408-5094

2906 S 20th St
Milwaukee, WI 53215
Phone (414) 385-8800

309 E North St
Waukesha, WI 53188
Phone (262) 408-2530

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Interoperability endpoints

  • Direct secure messaging: mhebert354277@direct.ochin.org

Organizations & group practices 7

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1568406346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 S 20TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153732",
            "telephone_number": "414-672-1353",
            "fax_number": "414-672-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 S 20TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153732",
            "telephone_number": "414-672-1353",
            "fax_number": "414-672-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "MARNI",
        "middle_name": "KOPENSKI",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "2040-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43969700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARNI",
            "last_name": "KOPENSKI",
            "middle_name": "LYNNE",
            "credential": "F.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.