John Christopher Coppola, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

5101016996 Issued in MI

Practice address

400 Lakebridge Plaza Dr
Ormond Beach, FL 32174-5157

Phone

(386) 677-9044

Fax

(386) 677-3083

NPI assigned

May 2, 2007

Last updated

Sep 14, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Parks Dermatology Center LLCGroup PAC ID 7315985686, 17 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.62 of 100Reported as group

Quality

100

Promoting interoperability

95

Improvement activities

40

Cost

72.89

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Parks Dermatology Center LLC

  • Dermatology Physician
  • Ormond Beach, FL
  • NPI 1629063680
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1346462181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LAKEBRIDGE PLAZA DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745157",
            "telephone_number": "386-677-9044",
            "fax_number": "386-677-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LAKEBRIDGE PLAZA DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745157",
            "telephone_number": "386-677-9044",
            "fax_number": "386-677-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "JOHN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5101016996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orjanette Marie Cooper-Bryant, APRN
• Derrick Christopher Cooper, RPH
• Jennifer S Cooper, D.M.D.
• Steven R Cooper, D.M.D.
• Pamela Jones Cope, APRN-C
• Coquina Center, LLC (Coquina Center)
• Cora Health Services Inc (CORA Physical Therapy - Ormond Beach)
• Cornerstone Medical Management, Inc.
• Sharen R Corpuz, ARNP
• Sherise Cortese, MS, RDN, LDN

• Dermatology Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.