Mary Kopacki, MS, LAT, ATC, PTA
Individual provider Active NPI Contractor · Browns Summit, NC
NPI 1962852970 · NPPES record last updated Jun 21, 2016
Key facts
- NPI
- 1962852970
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- LAT1595 (NC)
- Practice address
- 7 Crape Myrtle Cir
Browns Summit, NC 27214-9460 - Phone
- (561) 596-2870
- NPI assigned
- Jun 21, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL1739 | FL | MD | Contractor |
| LAT1595 | NC | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | LAT1595 | NC | Yes |
| Contractor | 171W00000X | AL1739 | FL |
Addresses
Primary practice location
7 Crape Myrtle Cir
Browns Summit, NC 27214-9460
Mailing address
7 Crape Myrtle Cir
Browns Summit, NC 27214-9460
Phone (561) 596-2870
Other providers in Browns Summit, NC
- Jawayne'S Transport LLC
- Christopher Johnson
- Lucretia Marie Johnson
- Auriel Brittany Jones
- Jordan'S Place of Peace
- Liggins Family Care Inc
- Liggins Hamily Care Inc
- Anita Kay Lindsey
- M Y Care
- M&S Supervised Living LLC
All providers in Browns Summit, NC · Contractor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.