Rebecca M Kopp Dunham, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20001 Issued in MN

Practice address

6046 14TH St S
Fargo, ND 58104-7340

Phone

(701) 404-0997

Fax

(701) 566-8876

NPI assigned

Dec 14, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rebecca Kopp Dunham PLLC

  • Clinical Social Worker
  • Fargo, ND
  • NPI 1386235190

  Clinical, MN, ND

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1659600054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6046 14TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047340",
            "telephone_number": "701-404-0997",
            "fax_number": "701-566-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6046 14TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047340",
            "telephone_number": "701-404-0997",
            "fax_number": "701-566-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPP DUNHAM",
        "first_name": "REBECCA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Rose Konz
• Ji M Koo, PHARMD
• Deidra Koons, RN
• Sri Vardhan Reddy Kooturu, M.D.
• Kurt William Kooyer, M.D.
• Alison Lynn Kopp, PT
• Jessica Kopp
• Kelsey Kopp
• Emily Kristine Korbl, RN
• Salmata Korgho

• All providers in Fargo, ND
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.