Individual provider Active NPI

Audrey Frances Kopp, CNM

  • Advanced Practice Midwife
  • Minneapolis, MN
National Provider Identifier
1811405582
Registry record updated Dec 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
453 Issued in MN
Practice address
701 Park Ave
Minneapolis, MN 55415-1623
Phone
(612) 873-0000
NPI assigned
Jan 16, 2018
Last updated
Dec 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 453 MN Primary
Maternal Newborn Registered Nurse 163WM0102X 2225809 MN

Addresses

Primary practice location

701 Park Ave
Minneapolis, MN 55415-1623

Mailing address

2040 Manning TRL N
Lake Elmo, MN 55042-9631
Phone (612) 327-8645

Other names 1

  • Audrey Mills Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210315001014 MN Practitioner - Certified Nurse Midwife (CNM) 1254747363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Womens Care PAGroup PAC ID 9638329394, 44 clinicians

Practice addresses (Care Compare)

2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone (651) 600-3035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Women's Care, P.a. CurrentSince Dec 9, 2020 Accepting new patients
Healtheast Woodwinds Hospital Past Accepting new patients
Healtheast St. John's Hospital Past Accepting new patients
Comprehensive Healthcare for Women, PA PastSince Jan 1, 2002 Accepting new patients

Locations

2603 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 209-8125

1687 Woodlane Dr
Woodbury, MN 55125
Phone (651) 209-6685

1687 Woodlane Dr
Ste 101
Woodbury, MN 55125
Phone (651) 209-6263

Interoperability endpoints

  • Direct secure messaging: audrey.kopp@mwc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FAHCDA

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.

NPI Registry JSON

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609027200000",
    "number": "1811405582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 MANNING TRL N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550429631",
            "telephone_number": "612-327-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPP",
        "first_name": "AUDREY",
        "middle_name": "FRANCES",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2020-12-27",
        "certification_date": "2020-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "453",
            "primary": true
        },
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "MN",
            "license": "2225809",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "MILLS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.