| Logan J Kopf, CRNA | |
|
300 Pershing Ave, Shenandoah, IA 51601-2355 | |
| (712) 246-7106 | |
| (712) 246-7357 |
| Full Name | Logan J Kopf |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 9 Years |
| Location | 300 Pershing Ave, Shenandoah, Iowa |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447609300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | D144014 (Iowa) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Avera St Anthony's Hospital | O' neill, NE | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Avera St Anthonys Hospital | 4486548203 | 17 |
| Entity Name | Avera St Anthonys Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043223654 PECOS PAC ID: 4486548203 Enrollment ID: O20040212000065 |
| Entity Name | Niobrara Valley Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063470953 PECOS PAC ID: 8921047754 Enrollment ID: O20050429000906 |
| Entity Name | Community Medical Center, Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1881643484 PECOS PAC ID: 6608776943 Enrollment ID: O20061222000136 |
| Entity Name | Niobrara Valley Hospital Corporation |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1063470953 PECOS PAC ID: 8921047754 Enrollment ID: O20071127000511 |
| Entity Name | Avera St Anthonys Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1891738936 PECOS PAC ID: 4486548203 Enrollment ID: O20071128000149 |
| Mailing Address | Practice Location Address |
|---|---|
| Logan J Kopf, CRNA 300 Pershing Ave, Shenandoah, IA 51601-2355 Ph: (712) 246-7106 | Logan J Kopf, CRNA 300 Pershing Ave, Shenandoah, IA 51601-2355 Ph: (712) 246-7106 |
Gary Mcintyre, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 300 Pershing Ave, Shenandoah, IA 51601 Phone: 712-246-1230 Fax: 712-246-7357 | |
Kristel Hodges, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 300 Pershing Ave, Shenandoah, IA 51601 Phone: 712-246-1230 Fax: 712-246-7264 |