KENNETH EDWARD KOPITZKE (NPI# 1326215724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326215724 |
| Entity Type | Individual |
| Full Name | KENNETH EDWARD KOPITZKE |
| Practice Address |
15100 Rescue Way Uscg Air Station Clearwater Clinic Clearwater FL 33762 |
| Practice Telephone | 7275351437 |
| Practice Fax Number | 7275354190 |
| Mailing Telephone | 7275351437 |
| Mailing Fax Number | 7275354190 |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-05-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | Other Service Providers |
| Street Address |
15100 RESCUE WAY USCG AIR STATION CLEARWATER CLINIC |
| City | CLEARWATER |
| State | FL |
| Zip Code | 33762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841276433 | Esan Odell Simon | Family Medicine | 15100 Rescue Way, Uscg Air Station Clearwater Medical Clinic, Clearwater, FL 33762-3502 | 2005-12-16 |
| 1063819621 | Daniel Coleman | Emergency Medical Technician, Basic | 15100 Rescue Way, Clearwater, FL 33762-3502 | 2014-11-25 |
| 1467629980 | Kristine Joy Distor | Military Health Care Provider | 15100 Rescue Way, Clearwater, FL 33762-3502 | 2008-05-14 |
| 1134396914 | Maryellen Tilly | Dental Hygienist | 15100 Rescue Way, Dental, Clearwater, FL 33762-3502 | 2008-05-12 |
| 1184767006 | Amber Lynn Barrick | Military Health Care Provider | 15100 Rescue Way, Clearwater, FL 33762 | 2007-02-14 |
| 1326180308 | Vivian Linette Pares | Dental Hygienist | 15100 Rescue Way, Clearwater, FL 33762 | 2007-02-13 |
| 1265572986 | Teresa Davis | Military Health Care Provider | 15100 Rescue Way, Clearwater, FL 33762 | 2007-02-08 |
| 1659411700 | Angela Karcinski | Physician Assistant | 15100 Rescue Way, Us Coast Guard Airsta Clearwater, Clearwater, FL 33762-3502 | 2007-02-07 |
| 1306986393 | Uscg Personal Service Center | Health Maintenance Organization | 15100 Rescue Way, Clearwater, FL 33762 | 2007-02-07 |
| 1609950674 | Uscg Air Station Clearwater | Clinic/Center | 15100 Rescue Way, Clearwater, FL 33762 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164051850 | Kimberly L Johnson | Home Health | 14055 46th Street North Suite 1102, Clearwater, FL 33762 | 2020-04-03 |
| 1134756869 | Pinellas County Sheriff's Office | Clinic/Center | Pinellas County Jail, 14400 49th Street North, Clearwater, FL 33762 | 2020-03-24 |
| 1285272815 | Gastro Florida Pharmacy, LLC | Pharmacy | 3001 Executive Drive, Suite 130, Clearwater, FL 33762 | 2019-12-13 |
| 1013401108 | Franz Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 4707 140th Ave N Ste 307, Clearwater, FL 33762 | 2018-06-21 |
| 1023502184 | Clearwater Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 4707 140th Ave N Ste 312, Clearwater, FL 33762 | 2018-06-21 |
| 1861803850 | Pinellas 1 Home Health Corp | Home Health | 4707 140th Avenue North Ste 106a, Clearwater, FL 33762 | 2014-05-13 |
| 1093065633 | Fast360 LLC | Transportation Broker | 10200 49th St N Ste 100, Clearwater, FL 33762 | 2012-09-11 |
| 1316253867 | Sophia Zavrou | Psychologist | 2325 Ulmerton Rd Ste 7g, Clearwater, FL 33762 | 2010-08-22 |
| 1356671275 | Suncoast Medicare Supply Company Inc. | Durable Medical Equipment & Medical Supplies | 4552b 107th Circle N, Clearwater, FL 33762 | 2009-12-29 |
| 1407006042 | Cynthia Rena' Williams | Physical Therapist | 13535 Feather Sound Dr., Suite 135, Clearwater, FL 33762 | 2008-09-19 |
| Find all providers in zip 33762 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467629980 | Kristine Joy Distor | Military Health Care Provider | 15100 Rescue Way, Clearwater, FL 33762-3502 | 2008-05-14 |
| 1184767006 | Amber Lynn Barrick | Military Health Care Provider | 15100 Rescue Way, Clearwater, FL 33762 | 2007-02-14 |
| 1265572986 | Teresa Davis | Military Health Care Provider | 15100 Rescue Way, Clearwater, FL 33762 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447872387 | Wesley Charles Wagers | Military Health Care Provider | 96 Mdos/sgof, 307 Boatner Road, Suite 114, Eglin Afb, FL 32542-1391 | 2020-05-14 |
| 1548808546 | Patrick S. Merriman | Military Health Care Provider | Navy Medicine Support Command Att: Medical Staff Svcs, Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2019-12-20 |
| 1023656451 | Operation Art District Healthcare LLC | Military Health Care Provider | 11 Nottingham Pl, Boynton Beach, FL 33426-8427 | 2019-12-17 |
| 1245881994 | Matthew Kerwin Church | Military Health Care Provider | 2020 Glenwood Hammock Rd, Deland, FL 32720-3805 | 2019-09-24 |
| 1326512443 | Francine Dorce I | Military Health Care Provider | 2300 Lynbrooke View Ct Apt 4, Orlando, FL 32822-4624 | 2019-01-12 |
| 1053805671 | Jeremy Ganz | Military Health Care Provider | 283 Twin Lakes Ln, Destin, FL 32541-2866 | 2018-06-18 |
| 1093224388 | Roland Vaughn | Military Health Care Provider | 970 Lake Carillon Dr Ste 300, St Petersburg, FL 33716-1130 | 2017-09-29 |
| 1134644750 | Kwanza Lincoln | Military Health Care Provider | 3520 Zemke Ave, Tampa, FL 33621 | 2017-08-04 |
| 1134576390 | Nathan Jamal Pena | Military Health Care Provider | 1320 Bailey Ave, Jacksonville, FL 32228-0028 | 2016-05-18 |
| 1780063644 | Samuel Herman | Military Health Care Provider | Naval Hospital Pensacola 6000 Us-98, Pensacola, FL 32512-0001 | 2015-05-26 |
| Find all providers with the same taxonomy | ||||
| City | CLEARWATER |
| Zip Code | 33762 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.