Kimberly Alison Kopp McNally

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A118363 Issued in CA

Practice address

1200 N State St
Room Cta7D
Los Angeles, CA 90033-1029

Phone

(323) 226-5700

NPI assigned

Oct 13, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Alison Kopp Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kmcnally753586@direct.ochin.org

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.

• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Venice, CA
  • NPI 1669418513
  Medicare reassignment NPD
• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Culver City, CA
  • NPI 1003842360
  NPD
• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Santa Monica, CA
  • NPI 1558397067
  NPD

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1831474576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "ROOM CTA7D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "ROOM CTA7D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNALLY",
        "first_name": "KIMBERLY",
        "middle_name": "ALISON KOPP",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A118363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "KOPP",
            "middle_name": "ALISON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Byron McNair Jr.
• Gabriel McNair
• Ronald McNair
• Elena Pilar McNally
• Jillian McNally, CMT
• Brian McNamara
• Griffin McNamara, MD
• Rilind McNamara
• Shannon McNamara, PMHNP
• Tierney Maureen Diane McNamara, LCSW

• Pediatrics Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.