Individual provider Active NPI

Brenda Marie Kopriva, MD

  • Surgery Physician
  • Colby, KS
National Provider Identifier
1598970642
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0433262 Issued in KS
Practice address
310 E College Dr
Colby, KS 67701-3716
Phone
(785) 462-6184
Fax
(785) 460-1490
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 26100 NE
Surgery Physician 208600000X 0433262 KS Primary

Addresses

Primary practice location

310 E College Dr
Colby, KS 67701-3716

Mailing address

310 E College Dr
Colby, KS 67701-3716
Phone (785) 462-6184

Other identifiers 1

IdentifierTypeStateIssuer
201117420AMedicaidKS

Other names 1

  • Brenda Marie Mellies Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150803001795 KS Practitioner - General Surgery 9234308149 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0433262KSMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rawlins County Health Center CurrentSince Apr 1, 2016 Accepting new patients
Citizens Medical Center, Inc Surgery Current Accepting new patients
Rawlins County Health Center CurrentSince Apr 1, 2016 Accepting new patients
Rawlins County Health Center Current Accepting new patients
Citizens Medical Center Inc CurrentSince Sep 7, 2015 Accepting new patients
Citizens Medical Center, Inc. CurrentSince Sep 7, 2015 Accepting new patients
Rawlins County Health Center Past Accepting new patients
Citizens Medical Center, Inc. Past Accepting new patients

Locations

707 Grant St
Atwood, KS 67730
Phone (785) 626-3211

100 E College Dr
Colby, KS 67701
Phone (785) 462-7511

310 E College Dr
Colby, KS 67701
Phone (785) 462-6184

Interoperability endpoints

  • Direct secure messaging: brenda.kopriva@khindirect.org
  • FHIR API: https://api.platform.athenahealth.com/13372/brand/1/csg/1/fhir/r4
  • Direct secure messaging: brenda.kopriva.1@13372.direct.athenahealth.com
  • Direct secure messaging: bkopriva661179@direct.ochin.org

Organizations & group practices 8

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1598970642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E COLLEGE DR",
            "city": "COLBY",
            "state": "KS",
            "postal_code": "677013716",
            "telephone_number": "785-462-6184",
            "fax_number": "785-460-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E COLLEGE DR",
            "city": "COLBY",
            "state": "KS",
            "postal_code": "677013716",
            "telephone_number": "785-462-6184",
            "fax_number": "785-460-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPRIVA",
        "first_name": "BRENDA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "26100",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "0433262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201117420A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "MELLIES",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colby, KS

Sources for this page

Verify at the official NPI Registry.