Individual provider Active NPI

Becky Lee Koepke, D.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1831107770
Registry record updated Jan 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7429 Issued in AZ
Practice address
16042 N 32ND St Ste C4D
Phoenix, AZ 85032-3806
Phone
(480) 628-3631
NPI assigned
Aug 4, 2006
Last updated
Jan 19, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7429 AZ Primary

Addresses

Primary practice location

16042 N 32ND St Ste C4D
Phoenix, AZ 85032-3806

Mailing address

2024 E Alameda Dr
Tempe, AZ 85282-4002
Phone (480) 628-3631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20051121000241 AZ Practitioner - ChiropracticPractitioner - Peripheral Vascular Disease 4486673423 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1236NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Koepke Clinic for Chiropractic PC Chiropractor CurrentSince Nov 8, 2004 Accepting new patients
Community Chiropractic Clinics PC Chiropractor Past Accepting new patients

Locations

16042 N 32nd St
Ste C4D
Phoenix, AZ 85032
Phone (480) 628-3631

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, 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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232323200000",
    "number": "1831107770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 E ALAMEDA DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852824002",
            "telephone_number": "480-628-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16042 N 32ND ST STE C4D",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323806",
            "telephone_number": "480-628-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPKE",
        "first_name": "BECKY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2009-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.