Individual provider Active NPI

Jennifer Grace Koplas, LMT

  • Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
  • Lockport, NY
National Provider Identifier
1679732309
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081N0008X
License
009566-1 Issued in NY
Practice address
473 Washburn St
Lockport, NY 14094-4963
Phone
(716) 438-2519
NPI assigned
Jun 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician 2081N0008X 009566-1 NY Primary

Addresses

Primary practice location

473 Washburn St
Lockport, NY 14094-4963

Mailing address

473 Washburn St
Lockport, NY 14094-4963
Phone (716) 438-2519

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

State licenses

LicenseStateTypeSpecialty
009566-1NYMDNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1679732309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 WASHBURN ST",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140944963",
            "telephone_number": "716-438-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 WASHBURN ST",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140944963",
            "telephone_number": "716-438-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPLAS",
        "first_name": "JENNIFER",
        "middle_name": "GRACE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "NY",
            "license": "009566-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.