Hayden Wade Kopetsky, PHARM. D

Primary specialty

PharmacistTaxonomy code 183500000X

License

58471 Issued in TX

Practice address

700 Scott and White Dr Ste 1.112
College Station, TX 77845-6441

Phone

(979) 207-0120

NPI assigned

Jun 21, 2019

Last updated

Jun 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Baylor Scott & White Health Enterprises, Inc.

  dba Baylor Scott & White Pharmacy #279

  • Community/Retail Pharmacy
  • Brenham, TX
  • NPI 1679246011
  NPD (past)
• Baylor Scott & White Health Enterprises, Inc.

  dba Baylor Scott & White Pharmacy #278

  • Community/Retail Pharmacy
  • College Station, TX
  • NPI 1962862383
  NPD (past)

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1902467855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SCOTT AND WHITE DR STE 1.112",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456441",
            "telephone_number": "979-207-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SCOTT AND WHITE DR STE 1.112",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456441",
            "telephone_number": "979-207-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPETSKY",
        "first_name": "HAYDEN",
        "middle_name": "WADE",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "58471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Alton Kniffin, A.T.C., L.A.T.
• Kristopher David Knoop, M.D.
• Allyson Koger
• Claire Macpherson Kolb, PA-C
• Christa Lynne Konderla, MA, CCC-SLP
• Deena Kothmann, FNP
• Joseph W Kraft, MD
• Jessica Anne Kral
• Allison Kraus-Saravia
• Theresa D Krause, M.D.

• Pharmacist in College Station, TX
• Providers in College Station, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.