Individual provider Active NPI

Kris A Koppy, LPC

  • Professional Counselor
  • Kansas City, MO
National Provider Identifier
1982048344
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2013011414 Issued in MO
Practice address
5904 E Bannister Rd
Kansas City, MO 64134-1141
Phone
(816) 966-0900
Fax
(816) 761-3433
NPI assigned
Apr 29, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2013011414 MO Primary

Addresses

Primary practice location

5904 E Bannister Rd
Kansas City, MO 64134-1141

Mailing address

1555 NE Rice Rd
Lees Summit, MO 64086-5849
Phone (816) 966-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215003579 MO Practitioner - Mental Health Counselor 4486098621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RediscoverGroup PAC ID 3375453517, 50 clinicians

Practice addresses (Care Compare)

5904 E Bannister Rd
Bannister Clinic
Kansas City, MO 64134-1141
Phone (816) 966-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013011414MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rediscover CurrentSince Jan 3, 2024 Accepting new patients
Rediscover CurrentSince Jan 3, 2024 Accepting new patients

Locations

8800 Blue Ridge Blvd
Ste 100
Kansas City, MO 64138
Phone (816) 347-4235

5904 E Bannister Rd
Kansas City, MO 64134
Phone (816) 966-0903

901 NE Independence Ave
Lees Summit, MO 64086
Phone (816) 246-1800

1555 NE Rice Rd
Lees Summit, MO 64086
Phone (816) 347-3069

7001 Blue Ridge Blvd
Raytown, MO 64133
Phone (816) 988-2739

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1982048344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 NE RICE RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865849",
            "telephone_number": "816-966-0900",
            "fax_number": "816-761-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5904 E BANNISTER RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641341141",
            "telephone_number": "816-966-0900",
            "fax_number": "816-761-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPY",
        "first_name": "KRIS",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-29",
        "last_updated": "2021-11-12",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2013011414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.