Active NPI
Nathan Allen Koep, ATC
- Specialist
- Buffalo, MN
National Provider Identifier
1871879809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2296
- Practice address
- 101 14TH St NE
Suite a
Buffalo, MN 55313-2927 - Phone
- (769) 684-3899
- NPI assigned
- Oct 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 2296 | MN | Primary |
Addresses
Primary practice location
101 14TH St NE
Suite a
Buffalo, MN 55313-2927
Mailing address
101 14TH St NE
Suite a
Buffalo, MN 55313-2927
Phone (769) 684-3899
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2296 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543104000000",
"number": "1871879809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 14TH ST NE",
"address_2": "SUITE A",
"city": "BUFFALO",
"state": "MN",
"postal_code": "553132927",
"telephone_number": "769-684-3899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 14TH ST NE",
"address_2": "SUITE A",
"city": "BUFFALO",
"state": "MN",
"postal_code": "553132927",
"telephone_number": "769-684-3899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOEP",
"first_name": "NATHAN",
"middle_name": "ALLEN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-21",
"last_updated": "2018-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MN",
"license": "2296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.