Individual provider Active NPI

Caroline Kuepper, PA-C

  • Physician Assistant
  • Sinton, TX
National Provider Identifier
1679778260
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02185 Issued in TX
Practice address
1143 E Sinton St
Sinton, TX 78387-2928
Phone
(361) 364-2804
Fax
(361) 364-5014
NPI assigned
Jun 15, 2007
Last updated
Oct 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA02185 TX Primary

Addresses

Primary practice location

1143 E Sinton St
Sinton, TX 78387-2928

Mailing address

1143 E Sinton St
Sinton, TX 78387-2928
Phone (361) 364-2804

Other identifiers 4

IdentifierTypeStateIssuer
377483YLPSOtherTXWELLMED PTAN
112554401MedicaidTX
813753OtherTXBCBS
342232101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210812003740 OH Practitioner - Physician Assistant 0042479305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3028 Navarre Ave
Oregon, OH 43616-3308
Phone (419) 697-6850

7010 Spring MDWS Dr W
Suite 101a
Holland, OH 43528-8137
Phone (419) 865-4448

7730 1St PL
Suite D
Oakwood Village, OH 44146-6720
Phone (440) 735-0438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Toledo Physicians LLC CurrentSince Jan 18, 2024 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1679778260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 E SINTON ST",
            "city": "SINTON",
            "state": "TX",
            "postal_code": "783872928",
            "telephone_number": "361-364-2804",
            "fax_number": "361-364-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 E SINTON ST",
            "city": "SINTON",
            "state": "TX",
            "postal_code": "783872928",
            "telephone_number": "361-364-2804",
            "fax_number": "361-364-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEPPER",
        "first_name": "CAROLINE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED PTAN",
            "identifier": "377483YLPS",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112554401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "813753",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342232101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sinton, TX

Sources for this page

Verify at the official NPI Registry.