BARBARA KUCEWICZ-KOPYTA, M.D. (KOPYTA INTERNAL MEDICINE, PC) NPI 1639476252

Clinic/Center in Albertville, AL

NPI 1639476252 Organization Clinic/Center CLIA Number 01D0997007 CLIA Certificate of Waiver

About BARBARA KUCEWICZ-KOPYTA, M.D. (KOPYTA INTERNAL MEDICINE, PC)

Barbara Kucewicz-kopyta, M.d. (kopyta Internal Medicine, Pc) is a provider established in Albertville, Alabama specializing in clinic/center. The NPI number of Barbara Kucewicz-kopyta, M.d. (kopyta Internal Medicine, Pc) is 1639476252 and was assigned on February 2011. The practitioner's primary taxonomy code is 261Q00000X with license number 00021174 (AL). The provider is registered as an organization and their NPI record was last updated 11 years ago. The provider's is doing business as Barbara Kucewicz-kopyta, M.d.. The authorized official of this NPI record is Dr. Barbara Elzbieta Kucewicz-kopyta M.d. (President)

The CLIA number of Barbara Kucewicz-kopyta, M.d. is 01D0997007 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Barbara Kucewicz-kopyta, M.d. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1639476252

Provider NameBARBARA KUCEWICZ-KOPYTA, M.D. (KOPYTA INTERNAL MEDICINE, PC)
Provider Location Address312 SAND MTN DR SE ALBERTVILLE, AL 35950
Provider Mailing Address312 SAND MTN DR SE ALBERTVILLE, AL 35950
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameBARBARA KUCEWICZ-KOPYTA, M.D.
Other Name TypeDoing Business As (3)
Enumeration Date02-16-2011
Last Update Date02-16-2011


Primary Taxonomy

Taxonomy Code261Q00000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
License No.00021174
License StateAL
Taxonomy DescriptionA facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Business Address

BARBARA KUCEWICZ-KOPYTA, M.D.
312 SAND MTN DR SE
ALBERTVILLE, AL
ZIP 35950
Phone: (256) 891-4577
Fax: (256) 891-4919

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Mailing Address

BARBARA KUCEWICZ-KOPYTA, M.D.
312 SAND MTN DR SE
ALBERTVILLE, AL
ZIP 35950
Phone: (256) 891-4577
Fax: (256) 891-4919



Authorized Official

Authorized Official NameDR. BARBARA ELZBIETA KUCEWICZ-KOPYTA M.D.
Authorized Official TitlePRESIDENT
Authorized Official Phone(256) 891-4577

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1639476252 is:

CLIA Number01D0997007
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
051501031MEDICARE PIN (08)AL
0515-01031OTHER (01)AL
009951470MEDICAID (05)AL
G61099MEDICARE UPIN (02)AL

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.