Individual provider Active NPI

Anthony Daniel Kopp, DO

  • Internal Medicine Physician
  • Clive, IA
National Provider Identifier
1750675716
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO-04706 Issued in IA
Practice address
12493 University Ave Ste 100
Clive, IA 50325-8286
Phone
(515) 358-9461
Fax
(515) 358-9489
NPI assigned
Jun 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO-04706 IA Primary

Addresses

Primary practice location

12493 University Ave Ste 100
Clive, IA 50325-8286

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 358-9461

Other practice location 1

1111 6th Ave
East Tower, Suite B3
Des Moines, IA 50314-2613
Phone (515) 358-0150

Other practice location 2

12493 University Ave Ste 100
Clive, IA 50325-8286
Phone (515) 358-0150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150814012732 IA Practitioner - Physical Medicine and Rehabilitation 1153636584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

12493 University Ave
Clive, IA 50325-8286

2006 N 4TH St
Indianola, IA 50125-4500

330 Laurel St
Suite 1200
Des Moines, IA 50314-3044
Phone (515) 643-6290

800 E 1St St
Ankeny, IA 50021-2077

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO-04706IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics, Inc CurrentSince Aug 1, 2015 Accepting new patients
Mercy Clinics, Inc. CurrentSince Aug 1, 2015 Accepting new patients
Mercy Clinics, Inc. Past Accepting new patients

Locations

12493 University Ave
Ste 100
Des Moines, IA 50325
Phone (515) 358-0060

1111 6th Ave
Ste B3
Des Moines, IA 50314
Phone (515) 358-0100

1401 Campus Dr
Des Moines, IA 50325
Phone (515) 381-6519

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

Interoperability endpoints

  • Direct secure messaging: akopp3949406@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1750675716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-358-9461",
            "fax_number": "515-358-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12493 UNIVERSITY AVE STE 100",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258286",
            "telephone_number": "515-358-9461",
            "fax_number": "515-358-9489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 6th Ave",
            "address_2": "East Tower, Suite B3",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503142613",
            "country_code": "US",
            "telephone_number": "515-358-0150",
            "fax_number": "515-358-0149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12493 University Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Clive",
            "state": "IA",
            "postal_code": "503258286",
            "country_code": "US",
            "telephone_number": "515-358-0150",
            "fax_number": "515-358-0149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOPP",
        "first_name": "ANTHONY",
        "middle_name": "DANIEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "DO-04706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.