Marjory D Koppelman
Individual provider Active NPI Family Nurse Practitioner · Moville, IA
NPI 1619690682 · NPPES record last updated Mar 16, 2026
Key facts
- NPI
- 1619690682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- A171240 (IA)
- Practice address
- 69 Pinney Rd
Moville, IA 51039-7500 - Phone
- (515) 402-6621
- NPI assigned
- Sep 23, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sikeston Emergency Group LLC
Potosi Emergency Group, LLC
Trinity Medical Center
Woodbury Emergency Group, PC
Practice addresses (Care Compare)
1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600
300 Health Way Dr
Potosi, MO 63664-1420
Phone (573) 438-5451
4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone (563) 742-3180
801 5TH St
Sioux City, IA 51101-1326
Phone (712) 279-2010
Hospital & facility affiliations
- Washington County Memorial Hospital
- Missouri Delta Medical Center
- Trinity - Bettendorf
- Lake Regional Health System
- St Lukes Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.04 of 100
- Quality
- 82.85
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA, MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221117002023 | IA | Practitioner - Nurse Practitioner | 0143698464 | Reassigns benefits to 7 organizations |
| I20260212000784 | MO | Practitioner - Nurse Practitioner | 0143698464 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A171240 | IA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delaware County Memorial Hospital | Current |
Accepting new patients | |
| Unity Healthcare | Current |
Accepting new patients | |
| Potosi Emergency Group, LLC | Current |
Accepting new patients | |
| Sikeston Emergency Group LLC | Current |
Accepting new patients | |
| Unity Healthcare | Current |
Accepting new patients | |
| Delaware County Memorial Hospital | Current |
Accepting new patients | |
| Iowa Emergency Physicians LLP | Current | Accepting new patients | |
| Sioux City Hospitalist Group, LLC | Current |
Accepting new patients | |
| Woodbury Emergency Group, PC | Current |
Accepting new patients | |
| Delaware County Memorial Hospital | Current | Accepting new patients | |
| Trinity Medical Center | Current |
Accepting new patients | |
| Trinity Medical Center | Current | Accepting new patients | |
| Iowa Emergency Physicians LLP | Current |
Accepting new patients | |
| Waterloo Emergency Physicians, LLC | Current |
Accepting new patients | |
| St Luke'S Methodist Hospital | Current | Accepting new patients |
Locations
4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724
1600 Morgan St
Keokuk, IA 52632
Phone (319) 524-7150
709 W Main St
Manchester, IA 52057
Phone (563) 927-3232
1518 Mulberry Ave
Muscatine, IA 52761
Phone (563) 262-4110
801 5th St
Sioux City, IA 51101
Phone (712) 279-2010
3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-7050
300 Health Way Dr
Potosi, MO 63664
Phone (573) 438-2977
1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600
Interoperability endpoints
- mkoppelman3949828@direct.trinity-health.org
- https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
- mkoppelman1216934@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A171240 | IA | Yes |
Addresses
Primary practice location
69 Pinney Rd
Moville, IA 51039-7500
Mailing address
69 Pinney Rd
Moville, IA 51039-7500
Other practice location 1
1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600
Other providers in Moville, IA
- Family Health Care of Siouxland LLC
- Wendy Kennedy
- Cinda Krause
- Byron Lee Linden
- Scott Linden
- Mercy Medical Services
- Moville Ambulance and Rescue Squad
All providers in Moville, IA · Family Nurse Practitioner in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.