Active NPI
Emily Nicole Koopman
- Athletic Trainer
- Kailua, HI
National Provider Identifier
1619459062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 6905 Harris Ave
Kailua, HI 96744 - Phone
- (315) 496-3966
- NPI assigned
- Sep 2, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
6905 Harris Ave
Kailua, HI 96744
Mailing address
399 Powder Creek Way
Dallas, GA 30157
Phone (678) 314-6207
Other practice location 1
399 Powder Creek Way
Dallas, GA 30157
Phone (678) 314-6207
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753315200000",
"number": "1619459062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "399 POWDER CREEK WAY",
"city": "DALLAS",
"state": "GA",
"postal_code": "30157",
"telephone_number": "678-314-6207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6905 HARRIS AVE",
"city": "KAILUA",
"state": "HI",
"postal_code": "96744",
"telephone_number": "315-496-3966"
}
],
"practiceLocations": [
{
"address_1": "399 Powder Creek Way",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "GA",
"postal_code": "30157",
"country_code": "US",
"telephone_number": "678-314-6207",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOOPMAN",
"first_name": "EMILY",
"middle_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-02",
"last_updated": "2025-07-24",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.