Individual provider Active NPI

Francis Julius Coppola III, MSW

  • Clinical Social Worker
  • Beacon Falls, CT
National Provider Identifier
1043413388
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
10 N Main St
Apt. SH-106
Beacon Falls, CT 06403-1133
Phone
(203) 720-7159
NPI assigned
Jun 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

10 N Main St
Apt. SH-106
Beacon Falls, CT 06403-1133

Mailing address

10 N Main St
Apt. SH-106
Beacon Falls, CT 06403-1133
Phone (203) 720-7159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20091029000598 CT Practitioner - Clinical Social Worker 2365589975 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Jun 26, 2015 Accepting new patients
Rushford Center, Inc. Clinical CurrentSince May 8, 2014 Accepting new patients
State of Connecticut CurrentSince Jun 26, 2015 Accepting new patients

Locations

165 Capitol Ave
Ste 2000
Hartford, CT 06106

883 Paddock Ave
Meriden, CT 06450
Phone (203) 630-5220

34 Park St
North Haven, CT 06519
Phone (203) 974-7417

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043413388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "address_2": "APT. SH-106",
            "city": "BEACON FALLS",
            "state": "CT",
            "postal_code": "064031133",
            "telephone_number": "203-720-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "address_2": "APT. SH-106",
            "city": "BEACON FALLS",
            "state": "CT",
            "postal_code": "064031133",
            "telephone_number": "203-720-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "FRANCIS",
        "middle_name": "JULIUS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beacon Falls, CT

Sources for this page

Verify at the official NPI Registry.