Individual provider Active NPI

Danelle Erin Koppes, NP

  • Family Nurse Practitioner
  • Shaker Heights, OH
National Provider Identifier
1699247288
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5378338052 Issued in KS
Practice address
20046 Walker Rd Ste 7
Shaker Heights, OH 44122-3645
Phone
(888) 316-0451
NPI assigned
Dec 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5024077 NC
Family Nurse Practitioner 363LF0000X 5378338052 KS Primary
Family Nurse Practitioner 363LF0000X 40974 OH

Addresses

Primary practice location

20046 Walker Rd Ste 7
Shaker Heights, OH 44122-3645

Mailing address

1968 17TH Rd
Clay Center, KS 67432-7420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, OH, NC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20201014000271 KS Practitioner - Nurse Practitioner 7810317864 Reassigns benefits to 1 organization
I20251223002409 OH Practitioner - Nurse Practitioner 7810317864 Reassigns benefits to 1 organization
I20260528004669 NC Practitioner - Nurse Practitioner 7810317864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Care Provider Group PAGroup PAC ID 6901217447, 115 clinicians

Practice addresses (Care Compare)

106 Langtree Village Dr
Suite 301
Mooresville, NC 28117-7594
Phone (888) 288-4715

20046 Walker Rd
Suite 7
Shaker Heights, OH 44122-3645
Phone (503) 208-5061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5378338052KSMDFamily Nurse Practitioner
5024077NCMDFamily Nurse Practitioner
40974OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Care Provider Group PA CurrentSince Dec 16, 2025 Accepting new patients

Locations

106 Langtree Village Dr
Ste 301
Mooresville, NC 28117
Phone (704) 457-1368

20046 Walker Rd
Ste 7
Shaker Heights, OH 44122
Phone (503) 208-5061

111 SW Naito Pkwy
Ste 200
Portland, OR 97204
Phone (503) 208-5061

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1699247288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1968 17TH RD",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674327420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20046 WALKER RD STE 7",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441223645",
            "telephone_number": "888-316-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPES",
        "first_name": "DANELLE",
        "middle_name": "ERIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-20",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5024077",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "5378338052",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "40974",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

Verify at the official NPI Registry.